NPIMap

Individual provider Active NPI

Charles R Warren, D.O.

  • Family Medicine Physician
  • Fleming Island, FL
National Provider Identifier
1154389112
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7329 Issued in FL
Practice address
4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822
Phone
(904) 269-4559
Fax
(904) 269-4597
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS7329 FL Primary

Addresses

Primary practice location

4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822

Mailing address

6520 Fort Caroline Rd
Jacksonville, FL 32277-2044
Phone (904) 745-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050714000322 FL Practitioner - Family Practice 7911933536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Partners of Northeast Florida LLCGroup PAC ID 7214832245, 15 clinicians

Practice addresses (Care Compare)

6484 Fort Caroline Rd
Jacksonville, FL 32277-2042
Phone (904) 744-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS7329FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Partners of Northeast Florida LLC Family Medicine CurrentSince Nov 20, 2004 Accepting new patients
Family Care Partners of Northeast Florida LLC Family Medicine Past Accepting new patients

Locations

4565 US Highway 17
Ste 106
Fleming Isle, FL 32003
Phone (904) 269-4559

9550 Regency Square Blvd
Ste 300
Jacksonville, FL 32225
Phone (904) 744-7300

1215 Dunn Ave
Jacksonville, FL 32218
Phone (904) 757-1998

6520 Fort Caroline Rd
Jacksonville, FL 32277
Phone (904) 725-7272

6484 Fort Caroline Rd
Jacksonville, FL 32277
Phone (904) 744-7300

14444 Beach Blvd
Ste 28
Jacksonville Beach, FL 32250
Phone (904) 323-0954

14011 Beach Blvd
Ste 210220
Jacksonville Beach, FL 32250
Phone (904) 367-2277

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27472/brand/1/csg/1/fhir/r4
  • Direct secure messaging: charles.warren.1@27472.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1154389112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772044",
            "telephone_number": "904-745-3618",
            "fax_number": "904-722-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 US HIGHWAY 17 STE 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034822",
            "telephone_number": "904-269-4559",
            "fax_number": "904-269-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.