Individual provider Active NPI

Patricia M Wortley, AUD

  • Audiologist
  • Grayson, KY
National Provider Identifier
1144692997
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
148705 Issued in KY
Practice address
250 McDavid Blvd
Grayson, KY 41143-1603
Phone
(606) 474-7835
NPI assigned
Oct 20, 2015
Last updated
Aug 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 148705 KY Primary
Audiologist 231H00000X SLPAUD00193936 KY

Addresses

Primary practice location

250 McDavid Blvd
Grayson, KY 41143-1603

Mailing address

12910 Shelbyville Rd
Suite 300
Louisville, KY 40243-1593
Phone (502) 244-2441

Other identifiers 1

IdentifierTypeStateIssuer
7100411460MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160202001875 KY Practitioner - Qualified Audiologist 1153625785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey Leider MD PLLCGroup PAC ID 0941469621, 19 clinicians

Practice addresses (Care Compare)

35 Augusta Ave
Ft Wright, KY 41011-3603
Phone 24852821166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148705KYMDAudiologist
SLPAUD00193936KYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Leider MD PLLC CurrentSince Mar 1, 2017 Accepting new patients
Jeffrey Leider MD PLLC Audiologist CurrentSince Mar 1, 2017 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

Interoperability endpoints

  • Direct secure messaging: patricia.wortley.p1@direct.360care.nextgenshare.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1144692997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431593",
            "telephone_number": "502-244-2441",
            "fax_number": "502-254-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MCDAVID BLVD",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431603",
            "telephone_number": "606-474-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTLEY",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "148705",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "SLPAUD00193936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100411460",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.