Individual provider Active NPI

Renee Warren, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1174600787
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
18101 Issued in WV
Practice address
4021 S 700 E
#300
Salt Lake City, UT 84107-2192
Phone
(800) 423-1605
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 23003 AZ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301050253 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 6956 ND
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35047691W OH
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 042-0007863 VT
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 22060-020 WI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 18101 WV Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X IL

Addresses

Primary practice location

4021 S 700 E
#300
Salt Lake City, UT 84107-2192

Mailing address

17 Temple St
Rutland, VT 05701-3513

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23003AZMDMental Health Counselor
036-087970ILMDAnatomic Pathology & Clinical Pathology Physician
35047691WOHMDAnatomic Pathology & Clinical Pathology Physician
042-0007863VTMDAnatomic Pathology & Clinical Pathology Physician
22060-020WIMDAnatomic Pathology & Clinical Pathology Physician
18101WVMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Pathology Consultants Anatomic Pathology & Clinical Pathology Past Accepting new patients

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174600787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 TEMPLE ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 S 700 E",
            "address_2": "#300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072192",
            "telephone_number": "800-423-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "RENEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "23003",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301050253",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ND",
            "license": "6956",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35047691W",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042-0007863",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "22060-020",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WV",
            "license": "18101",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.