Individual provider Active NPI

Matthew David Warren, M.D.

  • Family Medicine Physician
  • Peachtree City, GA
National Provider Identifier
1417067828
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15483 Issued in AL
Practice address
255 Smokerise Trce
Peachtree City, GA 30269-1301
Phone
(404) 226-4614
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15483 AL Primary

Addresses

Primary practice location

255 Smokerise Trce
Peachtree City, GA 30269-1301

Mailing address

255 Smokerise Trce
Peachtree City, GA 30269-1301
Phone (404) 226-4614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110104000659 GA Practitioner - Family PracticePractitioner - Emergency Medicine 4385629674 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Virginia Commonwealth University, School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

42 Main St
Suite 2a
Senoia, GA 30276-1889
Phone (943) 202-8430

509 N Expressway
Griffin, GA 30223-2073
Phone (943) 202-7790

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

  • Warm Springs Medical Center Hospital, Warm Springs, GA, CCN 111316
  • Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
71.9
Improvement activities
40
Cost
87.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15483ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Emergency Services, Inc. CurrentSince Jul 20, 2010 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Donalsonville Hospital Inc CurrentSince Sep 1, 2024 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

42 Main St
Ste 2A
Senoia, GA 30276
Phone (770) 301-0231

5995 Spring St
Warm Springs, GA 31830
Phone (706) 632-4374

Interoperability endpoints

  • Direct secure messaging: matthew.warren.1@19873.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1417067828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SMOKERISE TRCE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691301",
            "telephone_number": "404-226-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SMOKERISE TRCE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691301",
            "telephone_number": "404-226-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "15483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.