Individual provider Active NPI

Sean Warren, M.D.

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1063808137
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51617 Issued in KY
Practice address
215 Central Ave Ste 100
Louisville, KY 40208
Phone
(502) 588-8720
Fax
(502) 588-8721
NPI assigned
Apr 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP690 KY
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 51617 KY Primary

Addresses

Primary practice location

215 Central Ave Ste 100
Louisville, KY 40208

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4900

Other practice location 1

6041 Timber Ridge Dr
Prospect, KY 40059-8134
Phone (502) 928-0910

Other identifiers 1

IdentifierTypeStateIssuer
7100429320MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swarren89060@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2025 through Apr 1, 2027

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51617KYMDFamily Medicine Physician
TP690KYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1063808137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CENTRAL AVE STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40208",
            "telephone_number": "502-588-8720",
            "fax_number": "502-588-8721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6041 Timber Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Prospect",
            "state": "KY",
            "postal_code": "400598134",
            "country_code": "US",
            "telephone_number": "502-928-0910",
            "fax_number": "502-928-0911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP690",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "51617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100429320",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swarren89060@bhkydirect.com",
            "affiliation": "N",
            "address_1": "6041 Timber Ridge Dr",
            "city": "Prospect",
            "state": "KY",
            "country_code": "US",
            "postal_code": "400598134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.