Individual provider Active NPI

Robert Bruce Worth, MD

  • Family Medicine Physician
  • Aberdeen, WA
National Provider Identifier
1861580573
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00018292 Issued in WA
Practice address
1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055
Phone
(360) 533-6063
Fax
(360) 533-2204
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00018292 WA Primary

Addresses

Primary practice location

1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055

Mailing address

1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055
Phone (360) 533-6063

Other identifiers 1

IdentifierTypeStateIssuer
1928209MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080805000826 WA Practitioner - Family PracticePractitioner - Addiction Medicine 5395784490 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital Current Accepting new patients
Grays Harbor Community Hospital CurrentSince Mar 9, 2020 Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1006 N H St
Aberdeen, WA 98520
Phone (360) 537-6032

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1861580573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DR",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201055",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DR",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201055",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTH",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00018292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1928209",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.