Individual provider Active NPI

Priscilla Lydia Warnock, M.D.

  • Physician Assistant
  • Millersville, MD
National Provider Identifier
1982640702
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001680 Issued in MD
Practice address
8601 Veterans Hwy
Suite 204
Millersville, MD 21108-1547
Phone
(410) 729-0424
Fax
(410) 729-0492
NPI assigned
Jun 21, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0001680 MD Primary

Addresses

Primary practice location

8601 Veterans Hwy
Suite 204
Millersville, MD 21108-1547

Mailing address

PO Box 64042
Baltimore, MD 21264-4042

Other identifiers 3

IdentifierTypeStateIssuer
6002OtherMDBRAVO/ELDER HEALTH
69933OtherMDAMERIGROUP
970006233 CC0691OtherMDRR MEDICARE

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, Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0001680MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Washington Professional Services Inc. Current Accepting new patients
Arundel Physicians Associates, LLC Past Accepting new patients
Baltimore Washington Medical Center Inc. Past Accepting new patients

Locations

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

8601 Veterans Hwy
Ste 204
Millersville, MD 21108
Phone (410) 553-8092

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1982640702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64042",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 204",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-729-0424",
            "fax_number": "410-729-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNOCK",
        "first_name": "PRISCILLA",
        "middle_name": "LYDIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO/ELDER HEALTH",
            "identifier": "6002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "69933",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970006233 CC0691",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.