Individual provider Active NPI

Stafford Gay Warren, MD

  • Cardiovascular Disease Physician
  • Annapolis, MD
National Provider Identifier
1821081126
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D0067661 Issued in MD
Practice address
888 Bestgate Rd
Suite 215
Annapolis, MD 21401-3091
Phone
(410) 573-9805
Fax
(410) 573-9806
NPI assigned
Aug 23, 2005
Last updated
May 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X D0067661 MD Primary
Interventional Cardiology Physician 207RI0011X 10260 WV

Addresses

Primary practice location

888 Bestgate Rd
Suite 215
Annapolis, MD 21401-3091

Mailing address

888 Bestgate Rd
Suite 215
Annapolis, MD 21401-3091
Phone (410) 573-9805

Other identifiers 1

IdentifierTypeStateIssuer
417655300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090910000358 MD Practitioner - Cardiovascular Disease (Cardiology) 9436149309 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0067661MDMDCardiovascular Disease Physician
10260WVMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Cardiologic, LLP Cardiovascular Disease CurrentSince Dec 19, 2012 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Associated Radiologists, Inc. Past Accepting new patients
Charleston Cardiology Group PLLC Cardiovascular Disease Past Accepting new patients
Integrated Health Care Providers Past Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1821081126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 BESTGATE RD",
            "address_2": "SUITE 215",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013091",
            "telephone_number": "410-573-9805",
            "fax_number": "410-573-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 BESTGATE RD",
            "address_2": "SUITE 215",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013091",
            "telephone_number": "410-573-9805",
            "fax_number": "410-573-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "STAFFORD",
        "middle_name": "GAY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0067661",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WV",
            "license": "10260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417655300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.