William O Worthington, PT
Individual provider Active NPI Physical Therapist · Marshall, IL
NPI 1619981081 · NPPES record last updated Jun 6, 2012
Key facts
- NPI
- 1619981081
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070010429 (IL)
- Practice address
- 410 N Second Street
Marshall, IL 62441 - Phone
- (217) 826-2365
- Fax
- (217) 826-8120
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
408 N 2ND St
Marshall, IL 62441-1010
Phone (217) 826-2365
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070608000422 | IL | Practitioner - Physical Therapist in Private Practice | 1355449778 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05005753A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
408 N 2nd St
Marshall, IL 62441
Phone (217) 826-2361
410 N 2nd St
Marshall, IL 62441
Phone (217) 826-2358
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070010429 | IL | Yes |
| Physical Therapist | 225100000X | 05005753A | IN |
Addresses
Primary practice location
410 N Second Street
Marshall, IL 62441
Mailing address
PO Box 40
Marshall, IL 62441
Phone (217) 826-2365
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00397106 | Other | IL | RAILROAD UPIN |
| 1232012 | Other | IL | BLUE CROSS KINETIC 2010 |
| 080647 | Other | IL | HEALTH ALLIANCE |
| 010934666 | Other | IL | KINETIC TAX ID |
Other providers in Marshall, IL
- Walmart Inc.
- Andrea Lynn Warner
- Erica Diane Weber
- Wellum Chiropractic Center Inc
- Jeffrey B Wellum
- Brandi Renee York
All providers in Marshall, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.