Jesse Lee Worsham, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

T5701 Issued in TX

Practice address

211 E Southlake Blvd Ste 107
Southlake, TX 76092-6274

Phone

(817) 670-3857

Fax

(817) 259-2669

NPI assigned

May 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dallas County Mental Health & Mental Retardation Center

  dba Metrocare Services

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1023239886

  Child & Adolescent Psychiatry

  NPD (past)
• Texas Tech University Health Sciences Center Lubbock

  dba TTUHSC - Anesthesiology

  • Anesthesiology Physician
  • Lubbock, TX
  • NPI 1306894175
  NPD (past)
• Texas Texas University Health Sciences Center

  • Clinic/Center
  • Lubbock, TX
  • NPI 1780852343
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1194216663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E SOUTHLAKE BLVD STE 107",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926274",
            "telephone_number": "817-670-3857",
            "fax_number": "817-259-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SOUTHLAKE BLVD STE 107",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926274",
            "telephone_number": "817-670-3857",
            "fax_number": "817-259-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSHAM",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "T5701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Wolfe, M.S., CCC-SLP
• Brett Randon Wood, D.C.
• Toya Woodard, PTA
• Caylin Woods
• World Frozen Shoulder Institute Inc.
• Wound Care at Home PLLC
• Gregory Bob Wright, D.D.S.
• Jerrod Wright, D.C.
• Labrenda Kay Starr Wright
• Paul Sydney Wright, MD

• Child & Adolescent Psychiatry Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.