Individual provider Active NPI

Wendy D Dorworth, CFNP

  • Nurse Practitioner
  • Taylorville, IL
National Provider Identifier
1164612669
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209006667 Issued in IL
Practice address
1304 Burnett Dr
Taylorville, IL 62568-9519
Phone
(217) 321-9310
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209006667 IL Primary

Addresses

Primary practice location

1304 Burnett Dr
Taylorville, IL 62568-9519

Mailing address

1304 Burnett Dr
Taylorville, IL 62568-9519
Phone (217) 321-9310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wedie166783@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20070824000843 IL Practitioner - Nurse Practitioner 0941392682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1836 S Macarthur Blvd
Springfield, IL 62704-4030
Phone (217) 789-1403

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc Current Accepting new patients
HSHS Medical Group Inc CurrentSince Sep 1, 2013 Accepting new patients
SJL Health Systems Inc CurrentSince Sep 1, 2013 Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1836 S MacArthur Blvd
Springfield, IL 62704
Phone (217) 789-1403

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

1304 Burnett Dr
Taylorville, IL 62568
Phone (217) 321-9310

Interoperability endpoints

  • Direct secure messaging: wedie166783@ewd.direct.hshs.org

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.

Hospital & facility affiliations 3

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1164612669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BURNETT DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689519",
            "telephone_number": "217-321-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BURNETT DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689519",
            "telephone_number": "217-321-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORWORTH",
        "first_name": "WENDY",
        "middle_name": "D",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wedie166783@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1836 S MacArthur Blvd",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627044030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

Verify at the official NPI Registry.