Individual provider Active NPI

Aubrey Leon Warren, CO

  • Specialist
  • Norfolk, VA
National Provider Identifier
1255515300
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CO 003925 Issued in DE
Practice address
6320 N Center Dr
201
Norfolk, VA 23502-4009
Phone
(757) 892-5300
Fax
(757) 892-5303
NPI assigned
Dec 26, 2007
Last updated
Apr 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CO 003925 DE Primary

Addresses

Primary practice location

6320 N Center Dr
201
Norfolk, VA 23502-4009

Mailing address

6320 N Center Dr
201
Norfolk, VA 23502-4009
Phone (757) 892-5300

Other identifiers 4

IdentifierTypeStateIssuer
0482POtherBCBS OF NORTH CAROLINA
7701327MedicaidNC
9190511OtherVIRGINIA PREMIER
384410OtherBCBS OF VIRGINIA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO 003925DEMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Prosthetics & Orthotics, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1255515300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "AUBREY",
        "middle_name": "LEON",
        "credential": "CO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-26",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DE",
            "license": "CO 003925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH CAROLINA",
            "identifier": "0482P",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701327",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "9190511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF VIRGINIA",
            "identifier": "384410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.