Active NPI
Renee Warren, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Salt Lake City, UT
National Provider Identifier
1174600787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 18101
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 23003 | AZ | MD | Mental Health Counselor |
| 036-087970 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
| 35047691W | OH | MD | Anatomic Pathology & Clinical Pathology Physician |
| 042-0007863 | VT | MD | Anatomic Pathology & Clinical Pathology Physician |
| 22060-020 | WI | MD | Anatomic Pathology & Clinical Pathology Physician |
| 18101 | WV | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Fond Du Lac, WI
- NPI 1619052800
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.