Active NPI
Warlito Aviles Bautista, MD
- Internal Medicine Physician
- Jeffersonville, IN
National Provider Identifier
1750374237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01026833A
- Practice address
- 1311 Spring St
Jeffersonville, IN 47130-3705 - Phone
- (812) 282-3032
- Fax
- (812) 282-3059
- NPI assigned
- Aug 30, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01026833A | IN | Primary |
| Pulmonary Disease Physician | 207RP1001X | 01026833A | IN |
Addresses
Primary practice location
1311 Spring St
Jeffersonville, IN 47130-3705
Mailing address
1311 Spring St
Jeffersonville, IN 47130-3705
Phone (812) 282-3032
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100075350A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01026833A | IN | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1750374237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 SPRING ST",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303705",
"telephone_number": "812-282-3032",
"fax_number": "812-282-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 SPRING ST",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303705",
"telephone_number": "812-282-3032",
"fax_number": "812-282-3059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "WARLITO",
"middle_name": "AVILES",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01026833A",
"primary": true
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IN",
"license": "01026833A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100075350A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.