NPIMap

Individual provider Active NPI

Andrea J Warren, DO

  • Family Medicine Physician
  • Pontotoc, MS
National Provider Identifier
1992758775
Registry record updated Feb 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19237 Issued in MS
Practice address
345 Highway 15 N
Pontotoc, MS 38863-1105
Phone
(662) 489-7460
Fax
(662) 489-7938
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2011

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 19237 MS Primary

Addresses

Primary practice location

345 Highway 15 N
Pontotoc, MS 38863-1105

Mailing address

345 Highway 15 N
Pontotoc, MS 38863-1105
Phone (662) 489-7460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20060821000523 MS Practitioner - Family Practice 7315940996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pontotoc Health Services, Inc.Group PAC ID 6002895356, 18 clinicians

Practice addresses (Care Compare)

345 Hwy 15 N
Pontotoc Medical
Pontotoc, MS 38863-3311
Phone (662) 489-7430

Hospital & facility affiliations

  • North Mississippi Medical Ctr HHA Home health agency, Tupelo, MS, CCN 257002
  • Centerwell Home Health Home health agency, Tupelo, MS, CCN 257303
  • The Sanctuary Hospice House Hospice, Tupelo, MS, CCN 251623
  • Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308
  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006
  • Pontotoc Health & Rehab Center Nursing home, Pontotoc, MS, CCN 255270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19237MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pontotoc Health Services, Inc. Current Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Apr 1, 2015 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Pontotoc LTC, Inc Past Accepting new patients
Pontotoc Health Services, Inc. Past Accepting new patients

Locations

400 Doctors Dr
New Albany, MS 38652
Phone (662) 534-5036

345 Highway 15 N
Pontotoc, MS 38863
Phone (662) 489-7430

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

Interoperability endpoints

  • Direct secure messaging: andreawarren@nmhs.medalliesdirect.net

Organizations & group practices 6

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 7

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298246400000",
    "number": "1992758775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 HIGHWAY 15 N",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388631105",
            "telephone_number": "662-489-7460",
            "fax_number": "662-489-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HIGHWAY 15 N",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388631105",
            "telephone_number": "662-489-7460",
            "fax_number": "662-489-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "ANDREA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontotoc, MS

Sources for this page

Verify at the official NPI Registry.