Walter Richard Warren, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

18710 Issued in KY

Practice address

825 Second Avenue East
Suite A3
Bowling Green, KY 42101

Phone

(270) 796-6847

Fax

(270) 796-6841

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Commonwealth Health Corporation

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1306046115
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427057108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2697",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421022697",
            "telephone_number": "270-745-1467",
            "fax_number": "270-745-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SECOND AVENUE EAST",
            "address_2": "SUITE A3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-796-6847",
            "fax_number": "270-796-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "WALTER",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "18710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64187107",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tony Ware
• Warren County Health Care Services, Inc.
• Warren County Public Schools
• Ethan Patrick Warren, DPT
• Harry Warren III
• Kirsty Washam
• Kelsey Washburn, LPA
• Robert J. Wasson, M.D.
• Carl Edwin Waters
• Alice J Wathen

• Neurology Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Neurology Physician in Kentucky

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.