NPIMap

Individual provider Active NPI

Mark Warren, PA-C

  • Medical Physician Assistant
  • Abilene, TX
National Provider Identifier
1124384243
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00105 Issued in TX
Practice address
1111 Industrial Blvd
#2
Abilene, TX 79602-7929
Phone
(325) 795-9140
Fax
(325) 795-9150
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00105 TX Primary

Addresses

Primary practice location

1111 Industrial Blvd
#2
Abilene, TX 79602-7929

Mailing address

PO Box 7104
Abilene, TX 79608-7104
Phone (325) 795-9140

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HHM LLC Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients
Jamison Professional Counseling Center Inc Past Accepting new patients

Organizations & group practices 4

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1124384243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7104",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796087104",
            "telephone_number": "325-795-9140",
            "fax_number": "325-795-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 INDUSTRIAL BLVD",
            "address_2": "#2",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796027929",
            "telephone_number": "325-795-9140",
            "fax_number": "325-795-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.