NPIMap

Organization Active NPI

Warren Pediatrics, LLC

  • Pediatrics Physician
  • West Hartford, CT
National Provider Identifier
1043451214
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
042022 Issued in CT
Legal business name
WARREN PEDIATRICS, LLC
Practice address
81 S Main St Ste 5
West Hartford, CT 06107-2400
Phone
(860) 521-4044
Fax
(860) 521-3885
NPI assigned
Mar 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Dr. Matthew Scott Warren, MDNPI 1336216019
Title
Member
Phone
(860) 521-4044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 042022 CT Primary
Pediatric Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

81 S Main St Ste 5
West Hartford, CT 06107-2400

Mailing address

81 S Main St Ste 5
West Hartford, CT 06107-2400
Phone (860) 521-4044

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0094925Warren Pediatrics, LLC81 South Main Street Suite 5, West Hartford, CT 06107Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory

Locations

81 S Main St
Ste 5
West Hartford, CT 06107
Phone (860) 521-4044

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1043451214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 S MAIN ST STE 5",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072400",
            "telephone_number": "860-521-4044",
            "fax_number": "860-521-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 S MAIN ST STE 5",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072400",
            "telephone_number": "860-521-4044",
            "fax_number": "860-521-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-521-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "042022",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.