Mark Anthony Warren, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810000915 Issued in VA

Practice address

2580 Potters Rd
Virginia Beach, VA 23454-4324

Phone

(757) 498-9391

Fax

(757) 498-7073

NPI assigned

Jun 5, 2006

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beach Counseling Center LLCGroup PAC ID 5496172983, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6887/brand/1/csg/1/fhir/r4

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.

• Beach Counseling Center LLC

  • Professional Counselor
  • Virginia Beach, VA
  • NPI 1336510254
  Medicare reassignment Care Compare group NPD
• Ocean Psychiatric Group PC

  • Psychiatry Physician
  • Virginia Beach, VA
  • NPI 1205270147

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1154360329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 POTTERS RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544324",
            "telephone_number": "757-498-9391",
            "fax_number": "757-498-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 POTTERS RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544324",
            "telephone_number": "757-498-9391",
            "fax_number": "757-498-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "O80079",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007756232",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "018143",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "254187000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Denys Warren
• Jennifer C Warren
• Julie H. Warren, DMD
• Keyonna Blanche Warren
• Lani Marie Warren, M,D.
• Paul Douglas Warren, MD
• Shelly L Warren
• Toni Warren
• Valerie Warren
• Gregory J Warth, MD

• Clinical Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.