Individual provider Active NPI

Eddie Warren, M.D.

  • Specialist
  • Montgomery, AL
National Provider Identifier
1104935691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
025063 Issued in GA
Practice address
215 Perry Hill Rd
Montgomery, AL 36109-3725
Phone
(334) 272-4670
Fax
(334) 273-6203
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 025063 GA Primary

Addresses

Primary practice location

215 Perry Hill Rd
Montgomery, AL 36109-3725

Mailing address

215 Perry Hill Road
Montgomery, AL 36109
Phone (334) 272-4670

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025063GAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104935691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 PERRY HILL ROAD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36109",
            "telephone_number": "334-272-4670",
            "fax_number": "334-273-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PERRY HILL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361093725",
            "telephone_number": "334-272-4670",
            "fax_number": "334-273-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "025063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.