Roderick Warren, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209011922 Issued in IL

Practice address

1015 W Lawrence Ave
Chicago, IL 60640-5017

Phone

(773) 275-2586

NPI assigned

Jan 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Tapestry 360 Health

  dba Heartland Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1407981392
  NPD (past)

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1841680113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "737-275-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "773-275-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "RODERICK",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Warren, LPC, ALMFT
• Lee Ann Nicole Warren
• Megan Warren, LCPC
• Michael Warren
• Richard F Warren, MD
• Sarah B Warren, PH.D.
• Shannon Beth Warren
• Valerie J Warren, LCSW
• Zachary Alexander Warren, MD
• Alec Warrier

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.