NPIMap

Individual provider Active NPI

John Warren

  • Internal Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1013120104
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.27877 Issued in AL
Practice address
1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone
(205) 759-2582
Fax
(205) 759-2985
NPI assigned
May 7, 2007
Last updated
Mar 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.27877 AL Primary

Addresses

Primary practice location

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959

Mailing address

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone (205) 759-2582

Other identifiers 2

IdentifierTypeStateIssuer
P00772146OtherALRAILROAD MEDICARE
1013120104MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20080422000212 AL Practitioner - Internal Medicine 8921186628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuskaloosa Internal Medicine LLCGroup PAC ID 2264451137, 9 clinicians

Practice addresses (Care Compare)

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone (205) 759-2582

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.27877ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Healthcare Authority CurrentSince Aug 21, 2009 Accepting new patients
The DCH Health Care Authority CurrentSince Aug 21, 2009 Accepting new patients
Tuskaloosa Internal Medicine LLC Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
Glen Haven Health and Rehabilitation, LLC Past Accepting new patients

Locations

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 759-2582

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1013120104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042959",
            "telephone_number": "205-759-2582",
            "fax_number": "205-759-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042959",
            "telephone_number": "205-759-2582",
            "fax_number": "205-759-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.27877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00772146",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013120104",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.