Jennifer Warren

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Practice address

125 N Hartford Ave
Suite 7
Atlantic City, NJ 08401-3547

Phone

(609) 802-8476

NPI assigned

Jul 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Center for African American Health Disparities Education & Research

  • Health Service Clinic/Center
  • Atlantic City, NJ
  • NPI 1952906190

  Research Study

  NPD Authorized official

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1497138705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N HARTFORD AVE SUITE 7",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084013547",
            "telephone_number": "609-802-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N HARTFORD AVE",
            "address_2": "SUITE 7",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084013547",
            "telephone_number": "609-802-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NJ",
            "license": "25033051",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "NJ",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.caahder.org",
            "affiliation": "Y",
            "endpointDescription": "Encrypted client health information system",
            "affiliationName": "Center for African American Health Disparities Education & Research",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "125 N Hartford Ave",
            "address_2": "Suite 7",
            "city": "Atlantic City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "084013547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walgreen Co (Walgreens #19361)
• Jerry Elton Walker Jr.
• Jon R Walker
• Michelle Walsh, MSW, LCSW
• Debra Walters-Olaru, APN
• Zaiya Waseem, MD
• Thea Waters, LPN
• Christine Rose Watson, R.PH.
• Stephanie Weaver
• Joel G. Weiss, D.M.D

• Prevention Professional in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Prevention Professional in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; 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.