Adam Phillip Otworth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC379 Issued in KY

Practice address

398 Diederich Blvd
Ashland, KY 41101-7008

Phone

(606) 324-2055

Fax

(606) 326-1159

NPI assigned

Mar 19, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WV, KY3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters' Medical Center HHA Home health agency, Ashland, KY, CCN 187047
• King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aotworth89893@direct.kdhealth.us

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.

• Kings Daughters Medical Specialties Inc

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  Medicare reassignment Care Compare group
• Kings Daughters Medical Specialties Inc

  • Otolaryngology Physician
  • Ashland, KY
  • NPI 1497083539

  OH

  Medicare reassignment
• St. Mary'S Medical Management, LLC

  • Family Medicine Physician
  • Huntington, WV
  • NPI 1922155217
  Medicare reassignment
• Kings Daughters Medcial Specialties Inc

  • Hematology & Oncology Physician
  • Ashland, KY
  • NPI 1174967871

  Physician Assistant

  NPD
• Kings Daughters Medical Specialties Inc

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• St. Mary'S Medical Management, LLC

  • Orthopaedic Surgery Physician
  • Huntington, WV
  • NPI 1205596665

  Physician Assistant

  NPD

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

• Ashland Hospital Corporation

  • Home Health Agency
  • Ashland, KY
  • NPI 1386782050
  Care Compare affiliation
• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1851850762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-908-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 DIEDERICH BLVD",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017008",
            "telephone_number": "606-324-2055",
            "fax_number": "606-326-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 23rd St Ste G30",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411012881",
            "country_code": "US",
            "telephone_number": "606-327-0036",
            "fax_number": "606-326-1159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 1st Ave Rm 228",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021241",
            "country_code": "US",
            "telephone_number": "304-526-1311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1729 Kinneys Ln Ste 102",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456623166",
            "country_code": "US",
            "telephone_number": "740-351-0980",
            "fax_number": "740-351-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTWORTH",
        "first_name": "ADAM",
        "middle_name": "PHILLIP",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005730RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oral & Maxillofacial Surgery PSC Inc
• Alisha Rae Ortiz
• Crystal Osborn
• Jacob Allen Osborne, PHARM.D.
• Kimberly Ann Osborne, APRN
• Adrianne Otworth
• Our Lady Bellefonte Hospital, Inc
• Our Lady of Bellefonte Hospital
• Our Lady of Bellefonte Hospital
• Our Lady of Bellefonte Hospital

• Physician Assistant in Ashland, KY
• Providers in Ashland, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.