Individual provider Active NPI

Taylor Phillips, OD, MBA

  • Optometrist
  • Demopolis, AL
National Provider Identifier
1003438904
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-E34 Issued in AL
Practice address
1401 US Highway 80 W
Demopolis, AL 36732-4127
Phone
(334) 289-0466
NPI assigned
May 13, 2020
Last updated
May 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-E34 AL Primary

Addresses

Primary practice location

1401 US Highway 80 W
Demopolis, AL 36732-4127

Mailing address

PO Box 218
Gilbertown, AL 36908-0218
Phone (251) 458-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103001184 AL Practitioner - Optometry 0941610950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Basden EyecareGroup PAC ID 4981627502, 12 clinicians

Practice addresses (Care Compare)

1043 US Hwy 80 W
Demopolis, AL 36732-4116
Phone (334) 289-0466

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as individual
Quality
73.17
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
S-E34ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory Chad Green, OD, PC Optometrist CurrentSince Jul 29, 2020 Accepting new patients
Basden Eyecare Optometrist CurrentSince Aug 1, 2025 Accepting new patients
Gregory Chad Green OD Optometrist CurrentSince Jul 29, 2020 Accepting new patients
S. Douglas Owens, M.D., P.C. Past Accepting new patients

Locations

780 N Dean Rd
Auburn, AL 36830
Phone (334) 260-8511

1043 US Highway 80 W
Demopolis, AL 36732
Phone (334) 289-0466

1401 US Highway 80 W
Demopolis, AL 36732
Phone (334) 289-0466

124 16th St NE
Fayette, AL 35555
Phone (205) 932-5286

1490 N Bank Pkwy
Ste 120
Tuscaloosa, AL 35406
Phone (205) 861-2020

Networks

  • MS PPO
  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • MS PPO C-SNP
  • TN PPO C-SNP
  • MS PPO D-SNP
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • TN PPO

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1003438904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "GILBERTOWN",
            "state": "AL",
            "postal_code": "369080218",
            "telephone_number": "251-458-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 US HIGHWAY 80 W",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367324127",
            "telephone_number": "334-289-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TAYLOR",
        "credential": "OD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E34",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Demopolis, AL

Sources for this page

Verify at the official NPI Registry.