Warren Stacks MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9401498 Issued in NC

Legal business name

WARREN STACKS MD

Practice address

1400 Westgate Center Dr Ste 140
Winston Salem, NC 27103-3104

Phone

(336) 659-9440

Fax

(336) 659-9845

NPI assigned

Mar 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Warren Stacks, MDNPI 1740203090

Title

Owner

Phone

(336) 659-9440

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Warren D Stacks, MD

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1740203090
  NPD (past) Authorized official

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1376714816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30249",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271300249",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DR STE 140",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033104",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN STACKS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "STACKS",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-659-9440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9401498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "79116",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8979116",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Warndahl, MSN, NNP-BC, ARNP
• Alexander Burns Warner
• Cole Younger Warner, MA
• Rachel Lynne Warner, D.O
• Cynthia Ann Warnstaff, CFM
• Jennifer Marie Warren, CRNA
• John Frank Warren III, PH.D., PA-C
• John G Warren, PA
• Kaily Wilson Warren, FNP-C
• Katie Warren, PA-C

• Family Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.