Individual provider Active NPI

Michael Anthony Warren, APRN-CNP, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1104215383
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
89877 Issued in OK
Practice address
1603 Babcock Rd Unit 251
San Antonio, TX 78229-4708
Phone
(405) 361-7859
NPI assigned
Jan 12, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 89877 OK Primary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X 89877 OK

Addresses

Primary practice location

1603 Babcock Rd Unit 251
San Antonio, TX 78229-4708

Mailing address

1603 Babcock Rd Unit 251
San Antonio, TX 78229-4708
Phone (405) 361-7859

Other identifiers 1

IdentifierTypeStateIssuer
200582360AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1104215383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 BABCOCK RD UNIT 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294708",
            "telephone_number": "405-361-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 BABCOCK RD UNIT 251",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294708",
            "telephone_number": "405-361-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "89877",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OK",
            "license": "89877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200582360A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.