Individual provider Active NPI

Timarra Marie Warren, PMHNP-DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1265164008
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN311096 Issued in GA
Practice address
100 Cambridge St FL 14
Boston, MA 02114-2509
Phone
(646) 941-7645
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2307292 MA
Pediatric Registered Nurse 163WP0200X RN2307292 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN311096 GA Primary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X RN2307292 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2307292 MA

Addresses

Primary practice location

100 Cambridge St FL 14
Boston, MA 02114-2509

Mailing address

100 Cambridge St FL 14
Boston, MA 02114-2509
Phone (646) 941-7645

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
RN2307292MAMDPediatric Registered Nurse
RN311096GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fearfully and Beautifully Made Fitness, LLC. CurrentSince Sep 8, 2025 Accepting new patients

Locations

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

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.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1265164008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "646-941-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "646-941-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "TIMARRA",
        "middle_name": "MARIE",
        "credential": "PMHNP-DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2307292",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2307292",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN311096",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MA",
            "license": "RN2307292",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2307292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.