Individual provider Active NPI

Jerry Peyton Warren

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1700618162
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
927 Franklin St SE
Huntsville, AL 35801-4306
Phone
(256) 539-2728
NPI assigned
Aug 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2467 AL
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

927 Franklin St SE
Huntsville, AL 35801-4306

Mailing address

927 Franklin St SE
Huntsville, AL 35801-4306
Phone (256) 539-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241210000077 AL Practitioner - Physician Assistant 2567998990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Health System - the Orthopaedic Center LLCGroup PAC ID 0547624843, 172 clinicians

Practice addresses (Care Compare)

104 Liberty LN
Scottsboro, AL 35769-4163
Phone (256) 539-2728

927 Franklin St SE
Huntsville, AL 35801-4305
Phone (256) 539-2728

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2467ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Center PastSince Nov 10, 2021 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1700618162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-539-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-539-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "JERRY",
        "middle_name": "PEYTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "2467",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.