Active NPI
Tiffany LL Worthington, DO
- Family Medicine Physician
- Wiggins, MS
National Provider Identifier
1437222015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21273
- Practice address
- 805 Hall St
Wiggins, MS 39577-2110 - Phone
- (601) 928-4412
- Fax
- (601) 928-4792
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21273 | MS | Primary |
Addresses
Primary practice location
805 Hall St
Wiggins, MS 39577-2110
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 928-4412
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07133522 | Medicaid | MS | |
| P00739243 | Other | OH | RR MEDICARE |
| 2976874 | Medicaid | OH | |
| P00933673 | Other | MS | RAILROAD MEDICARE |
| 6041723 | Other | MS | HEALTHSPRING |
| 9988338 | Other | MS | AETNA |
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 Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1437222015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-928-4412",
"fax_number": "601-579-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 HALL ST",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395772110",
"telephone_number": "601-928-4412",
"fax_number": "601-928-4792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHINGTON",
"first_name": "TIFFANY",
"middle_name": "LL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "21273",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07133522",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00739243",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2976874",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00933673",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSPRING",
"identifier": "6041723",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9988338",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wiggins, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.