Individual provider Active NPI

Christina M. Warner-Metzger, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1265621668
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008519 Issued in IL
Practice address
5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1470
Phone
(773) 702-3127
Fax
(773) 702-9929
NPI assigned
Oct 22, 2007
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P0000002785 TN
Clinical Psychologist 103TC0700X 071.008519 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1470

Mailing address

5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1470
Phone (773) 702-3127

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.008519ILMDClinical Psychologist
P0000002785TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Tennessee 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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1265621668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 3077",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371470",
            "telephone_number": "773-702-3127",
            "fax_number": "773-702-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 3077",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371470",
            "telephone_number": "773-702-3127",
            "fax_number": "773-702-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER-METZGER",
        "first_name": "CHRISTINA",
        "middle_name": "M.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000002785",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.