Organization Active NPI

Katheryn M Warren MD PA

  • Specialist
  • Newark, DE
National Provider Identifier
1215187976
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C10004472 Issued in DE
Legal business name
KATHERYN M WARREN MD PA
Practice address
62 Omega Dr
E-62 Omega Professional Center
Newark, DE 19713
Phone
(302) 368-9611
Fax
(302) 368-3424
NPI assigned
Sep 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Aileen Lennon
Title
Billing Manager
Phone
(302) 368-9611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C10004472 DE Primary

Addresses

Primary practice location

62 Omega Dr
E-62 Omega Professional Center
Newark, DE 19713

Mailing address

E-62 Omega Dr
Omega Professional Center
Newark, DE 19713-2061
Phone (302) 368-9611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080915000305 DE Part B Supplier - Clinic/Group Practice 2961578042 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, DE

National Provider Directory

National Provider Directory

Locations

62 Omega Dr
#E
Newark, DE 19713
Phone (302) 368-9611

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1215187976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E-62 OMEGA DR",
            "address_2": "OMEGA PROFESSIONAL CENTER",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132061",
            "telephone_number": "302-368-9611",
            "fax_number": "302-368-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 OMEGA DR",
            "address_2": "E-62 OMEGA PROFESSIONAL CENTER",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-368-9611",
            "fax_number": "302-368-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERYN M WARREN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "LENNON",
        "authorized_official_first_name": "AILEEN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "302-368-9611"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "DE",
            "license": "C10004472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.