Warren Family Medical, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

85291 Issued in OH

Legal business name

WARREN FAMILY MEDICAL, INC.

Practice address

8700 E Market St
Suite 4
Warren, OH 44484-2340

Phone

(330) 856-7702

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Fareedah Zakiyyah Goodwin, M.D.

Title

President

Phone

(330) 856-7702

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1013106467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 E MARKET ST",
            "address_2": "SUITE 4",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842340",
            "telephone_number": "330-856-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 E MARKET ST",
            "address_2": "SUITE 4",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842340",
            "telephone_number": "330-856-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN FAMILY MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "FAREEDAH",
        "authorized_official_middle_name": "ZAKIYYAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-856-7702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OH",
            "license": "85291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2985328",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warren Dermatology and Mohs Surgery LLC.
• Warren Dialysis Center LLC
• Warren Endovascular Associates LLC
• Warren Eye Clinic Inc
• Warren Family Chiropractic & Physical Therapy, LLC
• Warren Gastro Endoscopy Ctr Inc
• Warren Medical Group Inc
• Warren Medical Specialists Inc
• Warren Ohio Hospital Company LLC
• Warren Ohio Hospital Company LLC

• Health Service Clinic/Center in Warren, OH
• Providers in Warren, OH by specialty
• Health Service Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.