Active NPI
Dennis Victor Worthington, MD
- Gastroenterology Physician
- Alamogordo, NM
National Provider Identifier
1417925009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 95380
- Practice address
- 2539 Medical Dr
Suite 107
Alamogordo, NM 88310-8720 - Phone
- (575) 446-5940
- Fax
- (575) 446-5944
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 95380 | NM | Primary |
| Gastroenterology Physician | 207RG0100X | G43294 | CA |
Addresses
Primary practice location
2539 Medical Dr
Suite 107
Alamogordo, NM 88310-8720
Mailing address
2539 Medical Dr Ste 107
Alamogordo, NM 88310-8720
Phone (575) 446-5940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H4189 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G43294 | CA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1417925009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2539 MEDICAL DR STE 107",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "883108720",
"telephone_number": "575-446-5940",
"fax_number": "575-446-5944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2539 MEDICAL DR",
"address_2": "SUITE 107",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "883108720",
"telephone_number": "575-446-5940",
"fax_number": "575-446-5944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHINGTON",
"first_name": "DENNIS",
"middle_name": "VICTOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NM",
"license": "95380",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G43294",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H4189",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alamogordo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.