Individual provider Active NPI

Dustin Matthew Worthington, DC

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1033700828
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14013 Issued in TX
Practice address
2300 W 7TH St Ste 114
Fort Worth, TX 76107-2311
Phone
(817) 381-1920
Fax
(817) 764-2731
NPI assigned
Feb 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14013 TX Primary

Addresses

Primary practice location

2300 W 7TH St Ste 114
Fort Worth, TX 76107-2311

Mailing address

2300 W 7TH St Ste 114
Fort Worth, TX 76107-2311
Phone (817) 381-1920

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.freeformchiropractic.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712003321 TX Practitioner - Chiropractic 1153723226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 W 7TH St
Suite 114
Fort Worth, TX 76107-2308
Phone 239970248412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14013TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Freeform Wellness PLLC CurrentSince Feb 1, 2021 Accepting new patients
Kaikoa LLC Chiropractor CurrentSince Mar 1, 2021 Accepting new patients
Freeform Chiropractic West 7TH LLC Chiropractor CurrentSince Jun 14, 2021 Accepting new patients

Locations

9453 N Beach St
Fort Worth, TX 76244
Phone (817) 372-0937

2300 W 7th St
Ste 114
Fort Worth, TX 76107
Phone 239970248412

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1033700828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W 7TH ST STE 114",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072311",
            "telephone_number": "817-381-1920",
            "fax_number": "817-764-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W 7TH ST STE 114",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072311",
            "telephone_number": "817-381-1920",
            "fax_number": "817-764-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "DUSTIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.freeformchiropractic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9453 N Beach St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762449059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.