Individual provider Active NPI

Warren L Stevens, PA-C

  • Physician Assistant
  • Elizabethton, TN
National Provider Identifier
1053621466
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4447 Issued in TN
Practice address
414 Northeast St
Elizabethton, TN 37643-2306
Phone
(423) 666-6174
NPI assigned
Oct 19, 2010
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA08781 TX
Physician Assistant 363A00000X 4447 TN Primary

Addresses

Primary practice location

414 Northeast St
Elizabethton, TN 37643-2306

Mailing address

279 Lazy Acres Dr
Waco, TX 76712-2832
Phone (210) 284-1938

Other practice location 1

1135 N Loop 340
Waco, TX 76705-2486
Phone (254) 867-1962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140604000983 TX Practitioner - Physician Assistant 6507000387 Reassigns benefits to 2 organizations
I20190409002363 NC Practitioner - Physician Assistant 6507000387
I20210910002164 TN Practitioner - Physician Assistant 6507000387 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

1112 N Main Ave
Erwin, TN 37650-1508
Phone (931) 253-1110

414 Northeast St
Elizabethton, TN 37643-2306
Phone (423) 666-6174

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Southeastern Physician Services PC Physician Assistant CurrentSince Jun 1, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 4, 2025 Accepting new patients
BH Services Southeast 1 PC Physician Assistant CurrentSince Nov 15, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 4, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 27, 2025 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 27, 2020 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 27, 2025 Accepting new patients
Urgent Care Institute of Abilene LLC PastSince Aug 1, 2009 Accepting new patients
Doctors Express of the Beaumont Area PA PastSince Sep 15, 2019 Accepting new patients

Locations

18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500

2565 N Washington Ave
Brownsville, TN 38012
Phone (731) 772-4199

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1053621466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 LAZY ACRES DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767122832",
            "telephone_number": "210-284-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NORTHEAST ST",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432306",
            "telephone_number": "423-666-6174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 N Loop 340",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767052486",
            "country_code": "US",
            "telephone_number": "254-867-1962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "WARREN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08781",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.