Individual provider Active NPI

Evin Elisabeth Worthington

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1851752554
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0203078 Issued in CO
Practice address
200 Quebec St BLDG 500-105
Denver, CO 80230-7150
Phone
(303) 364-6659
NPI assigned
Mar 9, 2016
Last updated
Dec 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0203078 CO Primary

Addresses

Primary practice location

200 Quebec St BLDG 500-105
Denver, CO 80230-7150

Mailing address

1565 Raleigh St Apt 302
Denver, CO 80204-1485
Phone (970) 903-8787

Other names 1

  • Dr. Evin Elisabeth Worthington Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Denver Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219002531 CO Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4789936683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0203078COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1851752554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 RALEIGH ST APT 302",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802041485",
            "telephone_number": "970-903-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 QUEBEC ST BLDG 500-105",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307150",
            "telephone_number": "303-364-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "EVIN",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "0203078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Denver",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 Quebec St Bldg 500-105",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802307150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EVIN",
            "last_name": "WORTHINGTON",
            "middle_name": "ELISABETH",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.