Active NPI
Richard Edward Warden II, D.C.
- Chiropractor
- Olive Branch, MS
National Provider Identifier
1326185638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 983
- Practice address
- 8912 Midsouth Ave
Olive Branch, MS 38654-2922 - Phone
- (662) 890-4410
- Fax
- (662) 890-4410
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 983 | MS | Primary |
Addresses
Primary practice location
8912 Midsouth Ave
Olive Branch, MS 38654-2922
Mailing address
8912 Midsouth Ave
Olive Branch, MS 38654-2922
Phone (662) 890-4410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00121579 | Medicaid | MS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 983 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326185638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8912 MIDSOUTH AVE",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386542922",
"telephone_number": "662-890-4410",
"fax_number": "662-890-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8912 MIDSOUTH AVE",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386542922",
"telephone_number": "662-890-4410",
"fax_number": "662-890-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDEN",
"first_name": "RICHARD",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MS",
"license": "983",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00121579",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olive Branch, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.