Active NPI
Michael R. Worthy, D.M.D.
- Dentist
- Hiawassee, GA
National Provider Identifier
1871777300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 09214
- Practice address
- 19 S. Main St.
Hiawassee, GA 30546 - Phone
- (706) 896-4154
- Fax
- (706) 896-4156
- NPI assigned
- Dec 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 09214 | GA | Primary |
Addresses
Primary practice location
19 S. Main St.
Hiawassee, GA 30546
Mailing address
P.O. Box 572
19 S. Main St.
Hiawassee, GA 30546
Phone (706) 896-4154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150723007496 | GA | Order and Referring Only - Dentist | 1456664168 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09214 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198022400000",
"number": "1871777300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 572",
"address_2": "19 S. MAIN ST.",
"city": "HIAWASSEE",
"state": "GA",
"postal_code": "30546",
"telephone_number": "706-896-4154",
"fax_number": "706-896-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 S. MAIN ST.",
"city": "HIAWASSEE",
"state": "GA",
"postal_code": "30546",
"telephone_number": "706-896-4154",
"fax_number": "706-896-4156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHY",
"first_name": "MICHAEL",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-19",
"last_updated": "2007-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "09214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hiawassee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.