Individual provider Active NPI

Diana W. Warren, DO

  • Emergency Medicine Physician
  • Haleyville, AL
National Provider Identifier
1417064536
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO523 Issued in AL
Practice address
42030 Highway 195
Suite C
Haleyville, AL 35565
Phone
(205) 485-7337
Fax
(205) 485-7393
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X DO523 AL
Emergency Medicine Physician 207P00000X DO523 AL Primary

Addresses

Primary practice location

42030 Highway 195
Suite C
Haleyville, AL 35565

Mailing address

PO Box 880
42030 Highway 195 Suite C
Haleyville, AL 35565-0880
Phone (205) 485-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040113000027 AL Practitioner - General Practice 1850290727 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
523ALMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Jun 10, 2021 Accepting new patients
Coastal Communities Physician Network, Inc. Past Accepting new patients
Diana Warren, D.O., P.C. Addiction Medicine PastSince Jul 1, 2003 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1417064536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "address_2": "42030 HIGHWAY 195 SUITE C",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "355650880",
            "telephone_number": "205-485-7337",
            "fax_number": "205-485-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42030 HIGHWAY 195",
            "address_2": "SUITE C",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "35565",
            "telephone_number": "205-485-7337",
            "fax_number": "205-485-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "DIANA",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AL",
            "license": "DO523",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haleyville, AL

Sources for this page

Verify at the official NPI Registry.