NPIMap

Organization Active NPI

Warren Otologic Group, Inc

  • Otolaryngology Physician
  • Warren, OH
National Provider Identifier
1720023351
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
WARREN OTOLOGIC GROUP, INC
Practice address
3893 E Market St
Warren, OH 44484-4706
Phone
(330) 856-4000
Fax
(330) 609-9910
NPI assigned
Jun 18, 2006
Last updated
Sep 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Authorized official

Name
Christine Egan
Title
Director of Revenue Cycle Managemen
Phone
(330) 651-6475

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X OH
Otolaryngology Physician 207Y00000X OH Primary
Otology & Neurotology Physician 207YX0901X OH

Addresses

Primary practice location

3893 E Market St
Warren, OH 44484-4706

Mailing address

3893 E Market St
Warren, OH 44484-4706
Phone (330) 856-4000

Other identifiers 1

IdentifierTypeStateIssuer
0092457MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000780 OH Part B Supplier - Clinic/Group Practice 8426952953 Receives reassigned benefits from 18 practitioners
Practice locations: Warren, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2032837Warren Otologic Group Inc Dba Lippy Group for ENT3893 East Market Street, Warren, OH 44484Certificate of waiverNov 15, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790208000000",
    "number": "1720023351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3893 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844706",
            "telephone_number": "330-856-4000",
            "fax_number": "330-609-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3893 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844706",
            "telephone_number": "330-856-4000",
            "fax_number": "330-609-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN OTOLOGIC GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGEMEN",
        "authorized_official_telephone_number": "330-651-6475"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092457",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.