Active NPI
Philip Craig Warren, B.S. O.T.
- Occupational Therapist
- Kingsport, TN
National Provider Identifier
1992859185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0000001007
- Practice address
- 130 Ravine Rd
Kingsport, TN 37660 - Phone
- (423) 224-5535
- Fax
- (423) 224-5544
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0000001007 | TN | Primary |
Addresses
Primary practice location
130 Ravine Rd
Kingsport, TN 37660
Mailing address
309 Hidden Acres Rd
Kingsport, TN 37664-5613
Phone (423) 349-4849
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000001007 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992859185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 HIDDEN ACRES RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376645613",
"telephone_number": "423-349-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 RAVINE RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37660",
"telephone_number": "423-224-5535",
"fax_number": "423-224-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "PHILIP",
"middle_name": "CRAIG",
"name_prefix": "Mr.",
"credential": "B.S. O.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "0000001007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.