Individual provider Active NPI

William Reuel Farnsworth, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Evansville, IN
National Provider Identifier
1790813293
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
S 42 Issued in MN
Practice address
550 W Virginia St
Evansville, IN 47710-1614
Phone
(812) 425-5194
Fax
(812) 426-9984
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X S 42 MN Primary

Addresses

Primary practice location

550 W Virginia St
Evansville, IN 47710-1614

Mailing address

550 W Virginia St
Evansville, IN 47710-1684
Phone (812) 425-5194

Other practice location 1

825 S 8th St
Parkside Professional Bldg, Suite 260
Minneapolis, MN 55404-1208
Phone (612) 347-7777

Other practice location 2

4121 Gateway Blvd
Newburgh, IN 47630-8954
Phone (812) 425-5194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140822000419 IN Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 3173797370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oral Surgery Group of Evansville IncGroup PAC ID 5991880106, 5 clinicians

Practice addresses (Care Compare)

550 W Virginia St
Evansville, IN 47710-1614
Phone (812) 425-5194

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S 42MNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Group of Evansville, Inc Oral and Maxillofacial Surgery CurrentSince Jul 16, 2014 Accepting new patients

Locations

550 W Virginia St
Evansville, IN 47710
Phone (812) 425-5194

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1790813293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101684",
            "telephone_number": "812-425-5194",
            "fax_number": "812-426-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101614",
            "telephone_number": "812-425-5194",
            "fax_number": "812-426-9984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 S 8th St",
            "address_2": "Parkside Professional Bldg, Suite 260",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041208",
            "country_code": "US",
            "telephone_number": "612-347-7777",
            "fax_number": "612-347-7757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4121 Gateway Blvd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308954",
            "country_code": "US",
            "telephone_number": "812-425-5194",
            "fax_number": "812-426-9984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "WILLIAM",
        "middle_name": "REUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "S 42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.