Active NPI
Fredrick Earl Worthy, ATC/L
- Athletic Trainer
- Wiggins, MS
National Provider Identifier
1679536734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0152
- Practice address
- 400 Border Ave E
Wiggins, MS 39577-2822 - Phone
- (601) 928-5492
- NPI assigned
- Apr 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0152 | MS | Primary |
Addresses
Primary practice location
400 Border Ave E
Wiggins, MS 39577-2822
Mailing address
328 Stillway Dr
Wiggins, MS 39577-2902
Phone (601) 503-0824
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT0152 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679536734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 STILLWAY DR",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395772902",
"telephone_number": "601-503-0824",
"fax_number": "601-928-6874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 BORDER AVE E",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395772822",
"telephone_number": "601-928-5492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHY",
"first_name": "FREDRICK",
"middle_name": "EARL",
"name_prefix": "Mr.",
"credential": "ATC/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0152",
"primary": true
}
],
"identifiers": [],
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.