Edward C Warren Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

30-0000233 Issued in VT

Practice address

24 Hanover St
Suite 3a
Lebanon, NH 03766-1334

Phone

(603) 448-2111

Fax

(603) 448-2443

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Mascoma Eyecare

  • Optometrist
  • Lebanon, NH
  • NPI 1407160120
  NPD (past) Authorized official

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1699719112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MAPLE ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050017029",
            "telephone_number": "603-448-2111",
            "fax_number": "603-448-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HANOVER ST",
            "address_2": "SUITE 3A",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661334",
            "telephone_number": "603-448-2111",
            "fax_number": "603-448-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "30-0000233",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003749",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005950",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muriel Eileen Ward, APRN
• Susan E. Ward, MSN, APRN, FNP-BC
• Thomas Nelson Ward, MD
• Lance Warhold, M.D.
• Yoo Min Han Warner
• Richard Washburn III, MD
• Tabitha Antoinette Washington, M.D., B.S.
• Garrett Thomas Wasp, M.D.
• Nicole Teresa Wasylyk, PA-C
• Joshua Waterman, DPT

• Optometrist in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.