Joseph Ray Warren Jr., PA

Individual provider Active NPI Medical Physician Assistant · Fremont, NC

NPI 1992804587 · NPPES record last updated Nov 25, 2013

Key facts

NPI
1992804587
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
001000431 (NC)
Practice address
109 S Sycamore St
Fremont, NC 27830-8710
Phone
(919) 242-4382
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Medical Center Incorporated (96 clinicians)

Practice addresses (Care Compare)

109 S Sycamore St
Fremont, NC 27830-8710
Phone (919) 242-4382

444 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0421

460 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0951

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070807000585 NC Practitioner - Physician Assistant 4486745395 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001000431NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated Current
since Aug 24, 2012
Accepting new patients
Goshen Medical Center, Inc Current
since Aug 24, 2012
Accepting new patients
Scotland Neck Family Medical Center, Inc. Past Accepting new patients
Goshen Medical Center, Inc. Past Accepting new patients

Locations

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

109 S Sycamore St
Fremont, NC 27830
Phone (919) 242-4382

Interoperability endpoints

  • Direct secure messaging: jwarren@goshenmedical.cloudcraftdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001000431 NC Yes

Addresses

Primary practice location

109 S Sycamore St
Fremont, NC 27830-8710

Mailing address

715 Antioch Church Rd
Zebulon, NC 27597-7177
Phone (919) 345-3692

Other providers in Fremont, NC

All providers in Fremont, NC · Medical Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.