NPIMap

Individual provider Active NPI

Laura Leigh Worthington, PA

  • Medical Physician Assistant
  • Traverse City, MI
National Provider Identifier
1992810360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004553 Issued in MI
Practice address
13491 S Bugai Rd
Traverse City, MI 49684-8421
Phone
(231) 947-4394
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004553 MI Primary

Addresses

Primary practice location

13491 S Bugai Rd
Traverse City, MI 49684-8421

Mailing address

13491 S Bugai Rd
Traverse City, MI 49684-8421
Phone (231) 947-4394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000564 MI Practitioner - Physician Assistant 1951300326 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Traverse Physician Services PCGroup PAC ID 2466963806, 119 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004553MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center CurrentSince Dec 7, 2024 Accepting new patients
Hospitalist Medicine Physicians of Michigan, PLLC CurrentSince Jul 16, 2019 Accepting new patients
Kalkaska Memorial Health Center Past Accepting new patients
Indigo Services, PLC Past Accepting new patients
Four Seasons Emergency Associates, PC Past Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992810360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13491 S BUGAI RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848421",
            "telephone_number": "231-947-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13491 S BUGAI RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848421",
            "telephone_number": "231-947-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "LAURA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.