Active NPI
Patricia M Wortley, AUD
- Audiologist
- Grayson, KY
National Provider Identifier
1144692997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 148705
- Practice address
- 250 McDavid Blvd
Grayson, KY 41143-1603 - Phone
- (606) 474-7835
- NPI assigned
- Oct 20, 2015
- Last updated
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100411460 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 148705 | KY | MD | Audiologist |
| SLPAUD00193936 | KY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey Leider MD PLLC | Current | Accepting new patients | |
| Jeffrey Leider MD PLLC | Audiologist | Current | Accepting new patients |
Locations
12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693
Interoperability endpoints
- 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.
-
dba OnHealthcare
- Geriatric Medicine (Family Medicine) Physician
- Ft Wright, KY
- NPI 1063788818
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
- Maurice White
- Ashley Lynn Whitley, PA-C
- Carrie Williams
- Stephanie Lou'Ellen Williams, MA.ED
- Penny Estella Woods, LPN
- Wright Care Home Medical Supplies Inc (Genesis Respiratory Services Inc)
- Wright Family Chiropractic PSC (Elite Chiropractic)
- Dustin E Wright, D.C.
- Whitney Yankey, CSW
- Rob Alexander Yates
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.