NPIMap

Individual provider Active NPI

Dustin K Worth, D.O.

  • Family Medicine Physician
  • Lapwai, ID
National Provider Identifier
1740307479
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-0501 Issued in ID
Practice address
111 Bever Grade Road
Lapwai, ID 83540-0367
Phone
(208) 843-2271
Fax
(208) 621-4995
NPI assigned
Mar 26, 2007
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-0501 ID Primary
Family Medicine Physician 207Q00000X 1918 ME

Addresses

Primary practice location

111 Bever Grade Road
Lapwai, ID 83540-0367

Mailing address

PO Drawer 367
Lapwai, ID 83540-0367
Phone (208) 843-2271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180612002124 TX Practitioner - Osteopathic Manipulative Medicine 8123103264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nez Perce Tribal Health AuthorityGroup PAC ID 0941288302, 16 clinicians

Practice addresses (Care Compare)

111 Bever Grade Rd
Lapwai, ID 83540-0367

PO Box
Suite 367
Lapwai, ID 83540-0367

PO Drawer
Suite 367
Lapwai, ID 83540-0367

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-0501IDMDFamily Medicine Physician
1918MEMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: dustinw@nimiipuuhealth.directbygreenway.com

Organizations & group practices 1

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 11

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1740307479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 367",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-621-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEVER GRADE ROAD",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-621-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTH",
        "first_name": "DUSTIN",
        "middle_name": "K",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0501",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapwai, ID

Sources for this page

Verify at the official NPI Registry.