Michael Wesley Duckworth, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

8803 Issued in TN

Practice address

1458 W Poplar Ave
Collierville, TN 38017-0630

Phone

(901) 759-5491

Fax

(901) 759-5493

NPI assigned

Sep 11, 2014

Sex

Male

Sole proprietor

No

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 TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.09 of 100Reported as group

Quality

50.47

Promoting interoperability

99

Improvement activities

40

Cost

67.33

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.duckworth.1@1366.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

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.

• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141
  Medicare reassignment Care Compare group NPD
• Campbell Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Carthage, TN
  • NPI 1669366068
  NPD
• Campbell Clinic

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Germantown, TN
  • NPI 1588619944
  NPD (past)
• CC Bpci PLC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1881387330
  NPD (past)

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1992106736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170630",
            "telephone_number": "901-759-5491",
            "fax_number": "901-759-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170630",
            "telephone_number": "901-759-5491",
            "fax_number": "901-759-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "MICHAEL",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "8803",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MS",
            "license": "4589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Mark Wallace PLLC
• Dr Ted S Cooper Optometry LLC
• Alexandra K Drake, PMHNP
• Harmony Draper
• Ritika Dubey
• William David Dunavant III, MD
• Christopher Dautrive Duperier, MD
• Brittany Dye, FNP-C,PMHNP-BC
• Susan D Earl, NP
• Emily Nicole Earnest, FNP

• Orthopedic Physical Therapist in Collierville, TN
• Providers in Collierville, TN by specialty
• Orthopedic Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.