Warren Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1877 Issued in ME

Legal business name

WARREN FAMILY MEDICINE

Practice address

191 Camden Rd
Warren, ME 04864-4207

Phone

(207) 273-6400

Fax

(207) 273-6402

NPI assigned

Jun 22, 2006

Organization subpart

No

Name

Jeffrey Wall, D.O.

Title

Owner

Phone

(207) 273-6400

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth T Wall, D.O.

  • Family Medicine Physician
  • Brunswick, ME
  • NPI 1598793762

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831135375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CAMDEN RD",
            "city": "WARREN",
            "state": "ME",
            "postal_code": "048644207",
            "telephone_number": "207-273-6400",
            "fax_number": "207-273-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CAMDEN RD",
            "city": "WARREN",
            "state": "ME",
            "postal_code": "048644207",
            "telephone_number": "207-273-6400",
            "fax_number": "207-273-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-273-6400",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Simmons, CADC
• Tracy Grafton Smith, RN
• Terence Michael Sokoloff, DDS
• Town of Warren
• Elspeth S. Trejo Savani, SLP
• Laura H Zell, LCPC-C

• All providers in Warren, ME
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.