Individual provider Active NPI

Michael Devin Taylor, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1003092842
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R983 Issued in AZ
Practice address
2927 N 7TH Ave
Peppertree - Family Medicine #3
Phoenix, AZ 85013-4102
Phone
(602) 406-3153
Fax
(602) 406-4122
NPI assigned
Jan 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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 R983 AZ Primary

Addresses

Primary practice location

2927 N 7TH Ave
Peppertree - Family Medicine #3
Phoenix, AZ 85013-4102

Mailing address

2927 N 7TH Ave
Peppertree - Family Medicine #3
Phoenix, AZ 85013-4102
Phone (602) 406-3153

Other identifiers 1

IdentifierTypeStateIssuer
R983OtherAZTRAINER PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000412 UT Practitioner - Family Practice 0749321842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1975 N State St
Orem, UT 84057-2028
Phone (801) 714-5500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R983AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Dec 6, 2009 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 6, 2009 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1975 N State St
Orem, UT 84057
Phone (801) 714-5000

395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1003092842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "address_2": "PEPPERTREE - FAMILY MEDICINE #3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "address_2": "PEPPERTREE - FAMILY MEDICINE #3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "DEVIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINER PERMIT",
            "identifier": "R983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.