NPIMap

Individual provider Active NPI

Warren R Ljungren, MD

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1891741872
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.052195 Issued in OH
Practice address
111 Harbert Dr
Beavercreek, OH 45440-5117
Phone
(937) 208-7575
Fax
(937) 208-7590
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.052195 OH Primary

Addresses

Primary practice location

111 Harbert Dr
Beavercreek, OH 45440-5117

Mailing address

111 Harbert Dr
Beavercreek, OH 45440-5117
Phone (937) 208-7575

Other identifiers 1

IdentifierTypeStateIssuer
0599820MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL wljungren1766@direct.premierhealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000369 OH Practitioner - Family Practice 5597808402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

111 Harbert Dr
Beavercreek, OH 45440-5117
Phone (937) 208-7575

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.052195OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Family Medicine Current Accepting new patients
Mvhe Inc CurrentSince Sep 1, 1997 Accepting new patients
Mvhe Inc CurrentSince Sep 1, 1997 Accepting new patients
Mvhe Inc Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

111 Harbert Dr
Dayton, OH 45440
Phone (937) 208-7575

38 Woodcroft Trl
Dayton, OH 45430
Phone (937) 427-3333

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1891741872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HARBERT DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454405117",
            "telephone_number": "937-208-7575",
            "fax_number": "937-208-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HARBERT DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454405117",
            "telephone_number": "937-208-7575",
            "fax_number": "937-208-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUNGREN",
        "first_name": "WARREN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.052195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0599820",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "wljungren1766@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "111 Harbert Dr",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454405117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.