Roger Lee Wortham, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

016463 Issued in LA

Practice address

600 Jefferson St Ste 909
Lafayette, LA 70501-6964

Phone

(337) 565-0200

Fax

(337) 565-0200

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 9

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Meharry Medical College School of Medicine, 1981

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• North Baltimore Center, Inc

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1720091044
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1427153386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93243",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705093243",
            "telephone_number": "337-565-0200",
            "fax_number": "337-565-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JEFFERSON ST STE 909",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016964",
            "telephone_number": "337-565-0200",
            "fax_number": "337-565-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Nantere Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705073240",
            "country_code": "US",
            "telephone_number": "337-565-0200",
            "fax_number": "410-235-7508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "ROGER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0064066",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "016463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "360 ALLIANCE - GILSBAR",
            "identifier": "07205",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSOLIDATED HEALTH PLANS (11405)",
            "identifier": "87843",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE (5867)",
            "identifier": "87726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA (5119)",
            "identifier": "61101",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF LOUISIANA",
            "identifier": "23738",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE FOR LIFE (12098)",
            "identifier": "TDDIR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (4433)",
            "identifier": "60054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA (4744)",
            "identifier": "62308",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VANTAGE HEALTH PLAN, INC, (5896)",
            "identifier": "72128",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlw@rworthammd.org",
            "affiliation": "N",
            "endpointDescription": "Provider Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "600 Jefferson St Ste 909",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705016964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Letha Woods, BA
• Victoria-Kathryn Woods
• Wesley Woods, DO
• Kacey Wooley
• Worth Counseling Group
• Wound Integrity Louisiana PMC
• Theresa Ann Wozencraft, PH.D.
• Cathryn Elizabeth Wright, N.P.
• Kristyn Q Wunder, FNP & AGACNP
• Emily J Wyatt, PMHNP BC

• Psychiatry Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.
• 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.