Warren J Beaver, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD033986-E Issued in PA

Practice address

1135 Lake St
Girard, PA 16417-1049

Phone

(814) 774-3155

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Erie, PA
  • NPI 1245209170
  NPD (past)
• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Girard, PA
  • NPI 1992185458
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1255322772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 COLONIAL AVE",
            "address_2": "SUITE A",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165063826",
            "telephone_number": "814-833-5653",
            "fax_number": "814-838-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 LAKE ST",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164171049",
            "telephone_number": "814-774-3155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3822 Colonial Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165063826",
            "country_code": "US",
            "telephone_number": "814-833-5653",
            "fax_number": "814-838-1153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "WARREN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD033986-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSU",
            "identifier": "000480409",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick M Andrews
• Aspire Counseling Services
• Andrea Jo Balogh, OTR
• Barabas Physical Therapy P.C.
• James John Barabas, P.T.
• Bebe Marin Speech Therapy LLC
• Makeda Bostwick, LPC
• Matthew Eric Brooks, PT
• Garrett Dean Brown, DPT
• Amy Rita Burger

• Family Medicine Physician in Girard, PA
• Providers in Girard, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.