Autumn Warnock

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

820 S Baxter Ave
Tyler, TX 75701-2225

Phone

(903) 592-6355

Fax

(903) 592-7680

NPI assigned

Jan 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: awarnock1334009@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1174945372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 RICKETY LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031706",
            "telephone_number": "903-533-8811",
            "fax_number": "903-533-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S BAXTER AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012225",
            "telephone_number": "903-592-6355",
            "fax_number": "903-592-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNOCK",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinsley Ward
• Ola Ward, RN, BSN
• Stephanie Ward, LCDC
• Toni Wardell
• Beverly Ware
• Amy Warren
• Anthony Chase Warren, CRNA
• Julia Michelle Warren, MA, LPC-A
• Margaret Anne Warren, D.O.
• Sumar Warren

• Medical Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.