JOHN TRACY WARREN (NPI# 1407871684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407871684 |
| Entity Type | Individual |
| Full Name | JOHN TRACY WARREN |
| Credential | MD |
| Practice Address |
1685 Macarthur St Green Bay WI 54301-2454 |
| Mailing Address |
Po Box 19070 Green Bay WI 54307-9070 |
| Practice Telephone | 9204351503 |
| Practice Fax Number | 9205692956 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-09-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 29771 | WI | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
29771-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31516000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356717524 | John Carmen Warren | Dentist | 618th Dental Company, Usa Dentac - Korea, Unit # 15652, Apo, AP 96205 | 2015-08-11 |
| 1023364791 | John Wesley Warren | Spec/Tech, Cardiovascular | 3760 W 54th St, Los Angeles, CA 90043-2335 | 2012-07-31 |
| 1942587860 | John Francis Warren | Occupational Therapist | 86 Virginia Rd, White Plains, NY 10603-1432 | 2011-11-05 |
| 1811207053 | John Lawson Warren IIi | Counselor | 3000 Market Street, Suite 530, Salem, OR 97301 | 2010-10-20 |
| 1609106442 | John Elijah Warren | Chiropractor | 2145 William St, Cape Girardeau, MO 63703-5817 | 2009-12-29 |
| 1073659413 | John Warren | Dentist | 20 Quail Ridge Rd, Hiram, GA 30141-2246 | 2007-01-30 |
| 1669530945 | John Joseph Warren | Psychologist | 23 Riverside St # 3, Needham, MA 02494-3016 | 2006-12-05 |
| 1861421315 | John Hoskins Warren | Optometrist | 1708 Scenic Hwy N, Snellville, GA 30078-2134 | 2006-06-30 |
| 1073577060 | John Frank Warren IIi | Psychologist | 840 W 4th St, Winston-salem, NC 27101-2502 | 2006-04-14 |
| 1386634400 | John F Warren | Ophthalmology | 33 Riddell St, Greenfield, MA 01301 | 2005-10-28 |
| Street Address |
1685 MACARTHUR ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790312171 | Sequoia Integrative Medical Services LLC | Family Medicine | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2020-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486121 | Integrity Senior Health | Family Medicine | 4347 Danbury Ln, Mount Pleasant, WI 53403-4022 | 2018-02-12 |
| 1508075409 | Jonny Alexander Macias Tejada | Family Medicine | 1020 N 12th St Ste 301, Milwaukee, WI 53233-1308 | 2007-05-21 |
| 1902907454 | Michael Lee Douglas | Family Medicine | 1110 Bergslien Street, Baldwin, WI 54002 | 2006-09-26 |
| 1801888938 | Mary C Ball | Family Medicine | 100 Silverado Dr, Stoughton, WI 53589-5406 | 2005-08-16 |
| 1275174922 | Leslie Ann Las | Family Medicine | 500 East Veterans Street, Tomah, WI 54660 | 2019-10-03 |
| 1558795914 | Richard London, M.d., L.L.C. | Family Medicine | 5000 W Chambers St, Milwaukee, WI 53210-1650 | 2013-08-21 |
| 1255518437 | Galia Paganelli | Family Medicine | 800 West Ave S, La Crosse, WI 54601-8806 | 2008-01-30 |
| 1235349077 | Ellen Turner Wenberg | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2007-05-23 |
| 1295952208 | Michael Stephen Garrity | Family Medicine | 916 Ferry St, La Crosse, WI 54601-4717 | 2007-04-19 |
| 1437373586 | Tracy L Sherman | Family Medicine | 2219 Garfield St, Two Rivers, WI 54241-2416 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.