Terry Lynn Warren, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA23282 Issued in FL

Practice address

9911 Corkscrew Rd.
Suite 101
Estero, FL 33928

Phone

(239) 768-2111

Fax

(239) 482-4404

NPI assigned

May 5, 2006

Last updated

Apr 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: twarren@icpeds.opdirect.net

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.

• Island Coast Pediatrics

  • Pediatrics Physician
  • Fort Myers, FL
  • NPI 1215962386
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1891743357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12550 PROFESSIONAL PARK DR.",
            "address_2": "SUITE 11",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9911 CORKSCREW RD.",
            "address_2": "SUITE 101",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "33928",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA23282",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA23282",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "PA23282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290499300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #09298)
• Lawrence Clifford Wallen III, D.C.
• Betcy Walter
• Warby Parker Inc.
• Matthew J Ward, M.D.
• C Renee Washington-Hyde, M.D.
• Angel Kay Weber
• Vanessa Weir, PA-C
• Lee A Welky, D.M.D.
• Elisa Valquiria Whitney, PHARMD

• Physician Assistant in Estero, FL
• Providers in Estero, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.