Active NPI
Warren Walter Gremmel Jr., MD
- Family Medicine Physician
- Deridder, LA
National Provider Identifier
1639285711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11483R
- Practice address
- 301 S Washington St
Deridder, LA 70634-4861 - Phone
- (337) 462-5227
- Fax
- (337) 462-5228
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11483R | LA | Primary |
Addresses
Primary practice location
301 S Washington St
Deridder, LA 70634-4861
Mailing address
301 S Washington St
Deridder, LA 70634-4861
Phone (337) 462-5227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11483R | Other | LA | MEDICAL LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11483R | LA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639285711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S WASHINGTON ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706344861",
"telephone_number": "337-462-5227",
"fax_number": "337-462-5228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S WASHINGTON ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706344861",
"telephone_number": "337-462-5227",
"fax_number": "337-462-5228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREMMEL",
"first_name": "WARREN",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "11483R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE #",
"identifier": "11483R",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deridder, LA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.