Individual provider Active NPI

Calvert Glendon Warren, MD

  • Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1083727846
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
36535 Issued in SC
Practice address
701 Grove Rd
Suite 200
Greenville, SC 29605-4210
Phone
(864) 455-8431
Fax
(864) 455-8981
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 188710-1 NY
Psychiatry Physician 2084P0800X 36535 SC Primary

Addresses

Primary practice location

701 Grove Rd
Suite 200
Greenville, SC 29605-4210

Mailing address

130 Highway 252
Anderson, SC 29621-5054
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
01499903MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001429 SC Practitioner - Psychiatry 3870781909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Rochester School of Medicine and Dentistry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

130 Hwy 252
Anderson, SC 29621-5054
Phone (803) 898-8405

250 Dewey Ave
Spartanburg, SC 29303-3009
Phone (864) 858-0366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
188710-1NYMDPsychiatry Physician
36535SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients

Locations

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

Organizations & group practices 2

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1083727846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HIGHWAY 252",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215054",
            "telephone_number": "864-797-6044",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "address_2": "SUITE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-8431",
            "fax_number": "864-455-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "CALVERT",
        "middle_name": "GLENDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "188710-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "36535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01499903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.