Organization Active NPI

Roderick L. Warren, M.D., P.C.

  • Neurology Physician
  • Evansville, IN
National Provider Identifier
1407914195
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
50003851A Issued in IN
Legal business name
RODERICK L. WARREN, M.D., P.C.
Practice address
801 Saint Marys Dr
Suite 303 East
Evansville, IN 47714-0511
Phone
(812) 477-1560
Fax
(812) 477-1595
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roderick Lance Warren, M.D.
Title
President
Phone
(812) 477-1560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 50003851A IN Primary

Addresses

Primary practice location

801 Saint Marys Dr
Suite 303 East
Evansville, IN 47714-0511

Mailing address

801 Saint Marys Dr
Suite 303 East
Evansville, IN 47714-0511
Phone (812) 477-1560

National Provider Directory

National Provider Directory

Locations

801 Saint Marys Dr
Ste 303E
Evansville, IN 47714
Phone (812) 477-1560

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407914195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR",
            "address_2": "SUITE 303 EAST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-477-1560",
            "fax_number": "812-477-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR",
            "address_2": "SUITE 303 EAST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-477-1560",
            "fax_number": "812-477-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODERICK L. WARREN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-477-1560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "50003851A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.