Individual provider Active NPI

William Addison Warren, M.D.

  • Internal Medicine Physician
  • Laurel, MD
National Provider Identifier
1669478285
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D13916 Issued in MD
Practice address
8871 Gorman Road
Ste 300
Laurel, MD 20723
Phone
(301) 498-3150
Fax
(301) 490-2411
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D13916 MD Primary
Pulmonary Disease Physician 207RP1001X D13916 MD

Addresses

Primary practice location

8871 Gorman Road
Ste 300
Laurel, MD 20723

Mailing address

8871 Gorman Road
Ste 300
Laurel, MD 20723
Phone (301) 498-3150

Other identifiers 3

IdentifierTypeStateIssuer
80160003OtherDCBLUE SHIELD NATIONAL AREA
411701800MedicaidMD
36778001OtherMDBLUE SHIELD OF MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110520000524 MD Practitioner - Internal Medicine 8224068986 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D13916MDMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians Inc CurrentSince Jan 1, 2014 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Warren & McClain MD CHTD Internal Medicine CurrentSince Apr 23, 1982 Accepting new patients
Lifebridge Community Physicians, Inc CurrentSince Jan 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Women First, OB-GYN Associates, LLC Past Accepting new patients

Locations

8871 Gorman Rd
Laurel, MD 20723
Phone (301) 498-3150

8871 Gorman Rd
Ste 300
Laurel, MD 20723
Phone (301) 498-3150

321 Prince George St
Laurel, MD 20707
Phone (301) 725-0600

9649 Belair Rd
Fl 2
Nottingham, MD 21236
Phone (410) 256-9340

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 6

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1669478285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8871 GORMAN ROAD",
            "address_2": "STE 300",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "301-498-3150",
            "fax_number": "301-490-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8871 GORMAN ROAD",
            "address_2": "STE 300",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "301-498-3150",
            "fax_number": "301-490-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "WILLIAM",
        "middle_name": "ADDISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D13916",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D13916",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NATIONAL AREA",
            "identifier": "80160003",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411701800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MD",
            "identifier": "36778001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.