Active NPI
Bryan Warner, M.D.
- Family Medicine Physician
- Richmond Heights, MO
National Provider Identifier
1710917604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2009032163
- Practice address
- 1034 S. Brentwood Blvd.
Ste 516
Richmond Heights, MO 63117 - Phone
- (877) 445-9050
- Fax
- (314) 735-1625
- NPI assigned
- Jul 4, 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 | 2009032163 | MO | Primary |
Addresses
Primary practice location
1034 S. Brentwood Blvd.
Ste 516
Richmond Heights, MO 63117
Mailing address
1034 S. Brentwood Blvd.
Ste 516
Richmond Heights, MO 63117
Phone (877) 445-9050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 10, 2010 through Sep 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009032163 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Physicians of Southern Illinois, PC | Family Medicine | Past | Accepting new patients |
| PC Associates, LLC | Family Medicine | Past | Accepting new patients |
| Bryan Warner MD PC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Belleville, IL
- NPI 1023034618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1710917604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 S. BRENTWOOD BLVD.",
"address_2": "STE 516",
"city": "RICHMOND HEIGHTS",
"state": "MO",
"postal_code": "63117",
"telephone_number": "877-445-9050",
"fax_number": "314-735-1625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 S. BRENTWOOD BLVD.",
"address_2": "STE 516",
"city": "RICHMOND HEIGHTS",
"state": "MO",
"postal_code": "63117",
"telephone_number": "877-445-9050",
"fax_number": "314-735-1625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARNER",
"first_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2009032163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Heights, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.