Organization Active NPI

Dr N W Worden PC

  • Primary Podiatric Medicine Podiatrist
  • Mishawaka, IN
National Provider Identifier
1003031204
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
07000536A Issued in IN
Legal business name
DR N W WORDEN PC
Practice address
2206 Lincolnway E
Mishawaka, IN 46544-3301
Phone
(574) 258-5060
Fax
(574) 258-5076
NPI assigned
Apr 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nelson William Worden, DPM
Title
President
Phone
(574) 258-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 07000536A IN Primary

Addresses

Primary practice location

2206 Lincolnway E
Mishawaka, IN 46544-3301

Mailing address

2206 Lincoln Way E
Mishawaka, IN 46544-3301
Phone (574) 258-5060

Other identifiers 2

IdentifierTypeStateIssuer
DP2429OtherINRAILROAD MEDICARE
200928250AMedicaidIN

National Provider Directory

National Provider Directory

Locations

2206 Lwe
Mishawaka, IN 46544
Phone (219) 258-5060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1003031204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 LINCOLN WAY E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443301",
            "telephone_number": "574-258-5060",
            "fax_number": "574-258-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 LINCOLNWAY E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443301",
            "telephone_number": "574-258-5060",
            "fax_number": "574-258-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR N W WORDEN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-15",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "WORDEN",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-258-5060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IN",
            "license": "07000536A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP2429",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200928250A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.