Mildred Pelletier Warren, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2015-01581 Issued in NC

Practice address

1165 Cedar Point Blvd
Suite F
Cedar Point, NC 28584-8023

Phone

(252) 752-4124

Fax

(252) 758-8954

NPI assigned

Jun 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Dermatology

Education

Eastern Virginia Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Dermatology PAGroup PAC ID 2860478542, 20 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Eastern Dermatology, P.a.

  • Dermatology Physician
  • Greenville, NC
  • NPI 1598759482
  Medicare reassignment Care Compare group NPD
• Eastern Dermatology PA

  • Dermatology Physician
  • Edenton, NC
  • NPI 1972715241
  NPD
• Easterm Dermatology, PA

  • Dermatology Physician
  • Greenville, NC
  • NPI 1457722043
  NPD (past)

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1083935928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SPRING FOREST RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347244",
            "telephone_number": "252-752-4124",
            "fax_number": "252-758-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 CEDAR POINT BLVD",
            "address_2": "SUITE F",
            "city": "CEDAR POINT",
            "state": "NC",
            "postal_code": "285848023",
            "telephone_number": "252-752-4124",
            "fax_number": "252-758-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MILDRED",
        "middle_name": "PELLETIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2015-01581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083935928",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten Leigh Stephenson, FNP-BC
• The Therapy Center of Cedar Point
• James Edward Tracy, PT, DPT,MS,OCS,MTC
• Rachel Tucker, D.M.D.
• Vitalize for Women
• Western Carteret Fire and EMS Department Inc
• Western Carteret Medical Center, PLLC

• Dermatology Physician in Cedar Point, NC
• Providers in Cedar Point, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.