Thomas Phillip Norsworthy, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD21646 Issued in TN

Practice address

708 W Forest Ave
Jackson, TN 38301-3901

Phone

(731) 425-6280

Fax

(731) 425-4922

NPI assigned

Jan 12, 2006

Sex

Male

Sole proprietor

No

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

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• West Tennessee Medical Group Inc

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• Anew Family Medical PLLC

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• Anew Family Medical PLLC

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  NPD (past)
• Bolivar General Hospital, Inc.

  • General Acute Care Hospital
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  NPD (past)
• Bolivar General Hospital, Inc.

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  NPD (past)
• Jackson Madison County General Hospital

  • General Practice Physician
  • Jackson, TN
  • NPI 1467493916

  Emergency Medicine

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2009.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1790764223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-425-6280",
            "fax_number": "731-425-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORSWORTHY",
        "first_name": "THOMAS",
        "middle_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD21646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3062153",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3067927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00109865",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jackson, TN
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.