Individual provider Active NPI

Deniese L Worthy, M.D.

  • Emergency Medicine Physician
  • Fraser, MI
National Provider Identifier
1982730990
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301084010 Issued in MI
Practice address
17717 Masonic
Fraser, MI 48026-3158
Phone
(586) 294-0600
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301084010 MI Primary

Addresses

Primary practice location

17717 Masonic
Fraser, MI 48026-3158

Mailing address

17717 Masonic
Fraser, MI 48026-3158
Phone (586) 294-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070727000804 MI Practitioner - Emergency Medicine 4082715594 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084010MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Emergency Physicians, P.C. Emergency Medicine CurrentSince Aug 1, 2008 Accepting new patients
American Current Care of Michigan PC Current Accepting new patients
American Current Care of Michigan PC CurrentSince Dec 6, 2021 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

26755 Ballard St
Harrison Twp, MI 48045
Phone (586) 465-5501

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

Interoperability endpoints

  • Direct secure messaging: ms_dworthy1@landmarkhealth-direct.org

Organizations & group practices 4

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1982730990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17717 MASONIC",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263158",
            "telephone_number": "586-294-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17717 MASONIC",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263158",
            "telephone_number": "586-294-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHY",
        "first_name": "DENIESE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301084010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fraser, MI

Sources for this page

Verify at the official NPI Registry.