Stephanie Warner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

10709 Issued in MS

Practice address

200 Hospital Dr
Tylertown, MS 39667-2020

Phone

(601) 876-5303

Fax

(601) 876-0653

NPI assigned

Sep 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Walthal Rural Health Clinic

  • Internal Medicine Physician
  • Tylertown, MS
  • NPI 1144530403

  Internal Medicine

  NPD (past)
• Walthall Rural Health Clinic

  • Family Medicine Physician
  • Tylertown, MS
  • NPI 1518275544

  Internal Medicine

  NPD (past)
• HMC Medical Center, LLC

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1194754358
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1720182322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672020",
            "telephone_number": "601-876-5303",
            "fax_number": "601-876-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672020",
            "telephone_number": "601-876-5303",
            "fax_number": "601-876-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11330",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "10709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06706285",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walthall General Hospital
• Walthall General Hospital
• Walthall Rural Health Clinic
• Walthall Rural Health Clinic
• Jonathan Warner, CSFA
• Williams Tylertown Pharmacy LLC
• Williams Tylertown Pharmacy LLC
• Kristen Williams
• Regina A Williams, CNP
• Vonzell Osborne Williams, M.D.

• All providers in Tylertown, MS
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.