Individual provider Active NPI

Taira Coryn Warren, FNP-C

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1760973739
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20186659 Issued in OR
Practice address
1345 Poplar Dr
Medford, OR 97504-5207
Phone
(541) 200-3240
Fax
(541) 200-3241
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201142261 OR
Family Nurse Practitioner 363LF0000X 20186659 OR Primary

Addresses

Primary practice location

1345 Poplar Dr
Medford, OR 97504-5207

Mailing address

1345 Poplar Dr
Medford, OR 97504-5207
Phone (541) 200-3240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20181211001545 OR Practitioner - Nurse Practitioner 2163766650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1345 Poplar Dr
Medford, OR 97504-5207
Phone (541) 200-3240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201142261ORMDRegistered Nurse
20186659ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogue Valley Health & Wellness LLC Family CurrentSince Aug 1, 2021 Accepting new patients
Apex Health and Wellness LLC CurrentSince Nov 27, 2024 Accepting new patients

Locations

1345 Poplar Dr
Medford, OR 97504
Phone (541) 200-3240

Interoperability endpoints

  • Direct secure messaging: tairawarren@rvhw.allscriptsdirect.net

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 3

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1760973739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 POPLAR DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045207",
            "telephone_number": "541-200-3240",
            "fax_number": "541-200-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 POPLAR DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045207",
            "telephone_number": "541-200-3240",
            "fax_number": "541-200-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "TAIRA",
        "middle_name": "CORYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201142261",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "20186659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.