Individual provider Active NPI

Rex Emerson Wortham, M.D.

  • Family Medicine Physician
  • Pinedale, WY
National Provider Identifier
1679580492
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4001A Issued in WY
Practice address
615 E Hennick St
Pinedale, WY 82941-5228
Phone
(307) 367-0099
Fax
(307) 367-3024
NPI assigned
Aug 2, 2006
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4001A WY Primary

Addresses

Primary practice location

615 E Hennick St
Pinedale, WY 82941-5228

Mailing address

615 E Hennick St
Pinedale, WY 82941-5228
Phone (307) 367-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20070104000514 WY Practitioner - Family PracticePractitioner - Emergency Medicine 0749278760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

625 E Hennick St
Pinedale, WY 82941-5228
Phone (307) 367-4133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.33 of 100Reported as group
Quality
89.53
Improvement activities
40
Cost
71.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4001AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivinson Memorial Hospital CurrentSince Apr 19, 2018 Accepting new patients
Sublette County Hospital District Family Medicine CurrentSince Dec 1, 2023 Accepting new patients
Sublette County Hospital District CurrentSince Dec 1, 2023 Accepting new patients
Ivinson Memorial Hospital CurrentSince Apr 19, 2018 Accepting new patients
Peak Emergency Physicians LLC Past Accepting new patients

Locations

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

Interoperability endpoints

  • Direct secure messaging: rwortham53774@direct.slhs.org
  • Direct secure messaging: rwortham777615@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1679580492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E HENNICK ST",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829415228",
            "telephone_number": "307-367-0099",
            "fax_number": "307-367-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E HENNICK ST",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829415228",
            "telephone_number": "307-367-0099",
            "fax_number": "307-367-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "REX",
        "middle_name": "EMERSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "4001A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinedale, WY

Sources for this page

Verify at the official NPI Registry.