NPIMap

Individual provider Active NPI

Paula Province Warren, M.D.

  • Neurology Physician
  • Hattiesburg, MS
National Provider Identifier
1932336302
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25817 Issued in MS
Practice address
301 S 28TH Ave
Hattiesburg, MS 39401-7233
Phone
(601) 261-1700
Fax
(601) 579-5240
NPI assigned
Jun 12, 2009
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 25817 MS
Neurology Physician 2084N0400X MD.30689 AL
Neurology Physician 2084N0400X 25817 MS Primary

Addresses

Primary practice location

301 S 28TH Ave
Hattiesburg, MS 39401-7233

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-1700

Other identifiers 1

IdentifierTypeStateIssuer
00882767MedicaidMS

Other names 1

  • Paula Province Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwarren74068@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140929000930 AL Practitioner - Neurology 2961647375 Reassigns benefits to 1 organization
I20180716003276 MS Practitioner - NeurologyPractitioner - Hematology/Oncology 2961647375 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Hematology/Oncology
Education
University of Alabama School of Medicine, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

14231 Seaway Rd
Suite 4001
Gulfport, MS 39503-4662
Phone (228) 213-8888

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Jan 12, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2014 Accepting new patients
Forest General Dba Highland Community Hospital CurrentSince Jan 12, 2021 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Hattiesburg Clinic PA CurrentSince Jun 25, 2018 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jun 25, 2018 Accepting new patients
Headache Specialists Neurology CurrentSince Jan 1, 2023 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

14231 Seaway Rd
Ste 4001
Gulfport, MS 39503
Phone (228) 213-8888

301 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-1700

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBIJCD/Endpoint/JBIJCD

Organizations & group practices 7

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.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1932336302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-1700",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017233",
            "telephone_number": "601-261-1700",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "PAULA",
        "middle_name": "PROVINCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MS",
            "license": "25817",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "MD.30689",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "25817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00882767",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwarren74068@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "PROVINCE",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.