Individual provider Active NPI

Michael L Warren, DC

  • Chiropractor
  • Medford, OR
National Provider Identifier
1790811511
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
272888 Issued in OR
Practice address
3560 National Rd
Suite 100
Medford, OR 97504-4008
Phone
(541) 734-7333
Fax
(541) 734-8802
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 272888 OR Primary

Addresses

Primary practice location

3560 National Rd
Suite 100
Medford, OR 97504-4008

Mailing address

3560 National Rd
Suite 100
Medford, OR 97504-4008
Phone (541) 734-7333

Other identifiers 1

IdentifierTypeStateIssuer
1710930151OtherORNPI# FOR ORGANIZATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050502000334 OR Practitioner - Chiropractic 3476592353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crater Chiropractic Clinic PCGroup PAC ID 9032158910, 2 clinicians

Practice addresses (Care Compare)

3560 National Dr
Suite 100
Medford, OR 97504-4008
Phone (541) 734-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2888ORMDClinical Psychologist
272888ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crater Chiropractic Clinic PC Chiropractor CurrentSince Jan 29, 2005 Accepting new patients
Jeffrey S. Taylor D.C., P.C. Chiropractor Past Accepting new patients

Locations

650 E Pine St
Ste 101
Central Point, OR 97502
Phone (541) 664-2275

3560 National Dr
Ste 100
Medford, OR 97504
Phone (541) 734-7333

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1790811511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 NATIONAL RD",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044008",
            "telephone_number": "541-734-7333",
            "fax_number": "541-734-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 NATIONAL RD",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044008",
            "telephone_number": "541-734-7333",
            "fax_number": "541-734-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "272888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI# FOR ORGANIZATION",
            "identifier": "1710930151",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.