Basic Information
Provider Information | |||||||||
NPI: | 1841432150 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WORTHINGTON | ||||||||
FirstName: | EMILY | ||||||||
MiddleName: | S | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BEST | ||||||||
OtherFirstName: | EMILY | ||||||||
OtherMiddleName: | S | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 901 E 104TH ST | ||||||||
Address2: | MAILSTOP 400 | ||||||||
City: | KANSAS CITY | ||||||||
State: | MO | ||||||||
PostalCode: | 641314517 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8165028752 | ||||||||
FaxNumber: | 8169329670 | ||||||||
Practice Location | |||||||||
Address1: | 4401 WORNALL RD | ||||||||
Address2: |   | ||||||||
City: | KANSAS CITY | ||||||||
State: | MO | ||||||||
PostalCode: | 641113220 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8169320340 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/01/2009 | ||||||||
LastUpdateDate: | 04/09/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2009001432 | MO | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 208M00000X | 05-35310 | KS | N |   | Allopathic & Osteopathic Physicians | Hospitalist |   | 207Q00000X | 53-35310 | KS | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 208M00000X | 2009001432 | MO | N |   | Allopathic & Osteopathic Physicians | Hospitalist |   |
No ID Information.