BILLY WORLEY, MD
Sports Medicine (Internal Medicine) Physician in COOKEVILLE, Tennessee. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: BILLY WORLEY, MD reported a CMS MIPS final score of 74.9609 out of 100, below the 83.1 national average, and filed 205 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
BILLY WORLEY, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
BILLY WORLEY, MD at a glance
Below national averagePrimary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Tennessee
How Sports Medicine (Internal Medicine) Physician compares to other specialties among Tennessee providers
Sports Medicine (Internal Medicine) Physician share within Tennessee
Sports Medicine (Internal Medicine) Physician is one of the more visible NUCC categories in Tennessee
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
BILLY WORLEY, MD's 2023 MIPS final score plotted against the Sports Medicine (Internal Medicine) Physician national average
- MIPS Final Score
- 74.9609/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Sports Medicine (Internal Medicine) Physician) — 74.9609/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Cost dim CMS Cost category
- Specialty volume Sports Medicine (Internal Medicine) Physician US NPIs
74.9609/100 MIPS final score — 8.1 pts below the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Sports Medicine (Internal Medicine) Physician. Quality dim: 64.7209. Cost dim: 60.1488.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
BILLY WORLEY, MD is a Sports Medicine (Internal Medicine) Physician provider practicing in COOKEVILLE, Tennessee, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1649536434. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.
BILLY WORLEY, MD appears in the CMS NPPES registry as a Sports Medicine (Internal Medicine) Physician provider holding MD credentials at 105 S WILLOW AVE, COOKEVILLE, TN, 38501, with a listed phone of (931) 526-9518. NPI 1649536434 was issued on 04/05/2012. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what WORLEY most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 205 prescription claims written by this provider, covering 173 Medicare beneficiaries and totaling roughly $1K in drug spend, split 6% brand-name and 94% generic by claim count, with an opioid prescribing rate of 19.0%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 74.9609/100 for the 2023 performance year (Quality 64.7209, Cost 60.1488), compared with the national average of 83.1.
Sports Medicine (Internal Medicine) Physician is a narrow specialty nationwide, with 292 enrolled providers across 43 states and an average of 1,267 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1649536434 |
|---|---|
| Specialty | Sports Medicine (Internal Medicine) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 04/05/2012 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm BILLY WORLEY, MD's current license status, disciplinary history, and board certifications with the Tennessee Board of Medical Examiners in Tennessee before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where BILLY WORLEY, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) — CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for BILLY WORLEY, MD. Source: openpaymentsdata.cms.gov.
Total received
$17
Largest payer
Smith+Nephew, Inc.
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Brand vs generic prescribing mix · Generic-heavy
6% brand-name claims vs 94% generic, on 205 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 205
- Total Day Supply
- 2,326
- Brand vs Generic
- 6% brand / 94% generic
- Brand Drug Cost
- $157
- Generic Drug Cost
- $1K
- Opioid Claims
- 39 (19.0% rate)
- Antibiotic Claims
- 11
Patient Demographics
- Average Patient Age
- 72.9 years
- Avg HCC Risk Score
- 0.99
- Gender Split
- 56% female / 44% male
- Age Distribution
- <65: 15, 65-74: 80, 75-84: 60, 85+: 18
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Methylprednisolone | 90 |
| Meloxicam | 41 |
| Tramadol Hcl | 31 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Sports Medicine (Internal Medicine) Physician Overview
How BILLY WORLEY, MD fits within the Sports Medicine (Internal Medicine) Physician landscape nationally.
BILLY WORLEY, MD's 205 claims are below the specialty average of 1,267.
Nearby Sports Medicine (Internal Medicine) Physician Providers in Tennessee
Other clinicians with the same primary specialty enrolled in Tennessee, drawn from the same CMS NPPES roster as WORLEY.
Compare Sports Medicine (Internal Medicine) Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology