Individual provider Active NPI

Russell Nathan Ludwig Worthen, NP-C

  • Acute Care Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1093190795
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5007800 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-3506
Phone
(336) 716-2011
NPI assigned
Jul 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5007800 NC
Acute Care Nurse Practitioner 363LA2100X 5007800 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-3506

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2011

Other practice location 1

601 N Elm St
High Point, NC 27262-4331
Phone (828) 699-1880

Other practice location 2

250 Hospital Dr
Lexington, NC 27292-6792
Phone (828) 699-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000111 NC Practitioner - Nurse Practitioner 3577863349 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5007800NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 6, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Jun 6, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 6, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Jun 6, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients

Locations

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

Interoperability endpoints

  • Direct secure messaging: rworthen2753327@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1093190795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271573506",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Elm St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624331",
            "country_code": "US",
            "telephone_number": "828-699-1880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272926792",
            "country_code": "US",
            "telephone_number": "828-699-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDWIG WORTHEN",
        "first_name": "RUSSELL",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007800",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5007800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.