Active NPI
Petra K Warren, M.D.
- Family Medicine Physician
- Chesnee, SC
National Provider Identifier
1861450397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22043
- Practice address
- 230 S Alabama Ave
Chesnee, SC 29323-1504 - Phone
- (864) 461-4951
- Fax
- (864) 461-4956
- NPI assigned
- May 3, 2006
- Last updated
- Jun 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22043 | SC | Primary |
Addresses
Primary practice location
230 S Alabama Ave
Chesnee, SC 29323-1504
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22043 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spartanburg Hospital for Restorative Care | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Spartanburg, SC
- NPI 1649293580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1861450397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 743070",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303743070",
"telephone_number": "864-560-4304",
"fax_number": "864-560-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S ALABAMA AVE",
"city": "CHESNEE",
"state": "SC",
"postal_code": "293231504",
"telephone_number": "864-461-4951",
"fax_number": "864-461-4956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "PETRA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "22043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesnee, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.