NPIMap

Individual provider Active NPI

Lee B Taylor Jr., MD

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1003863929
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9525 Issued in SC
Practice address
3021 Reidville Rd
Spartanburg, SC 29301-5643
Phone
(864) 576-9201
Fax
(864) 576-6584
NPI assigned
May 27, 2006
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 9525 SC Primary

Addresses

Primary practice location

3021 Reidville Rd
Spartanburg, SC 29301-5643

Mailing address

3021 Reidville Rd
Spartanburg, SC 29301-5643
Phone (864) 576-9201

Other identifiers 3

IdentifierTypeStateIssuer
095257MedicaidSC
GP4988OtherSCMEDICAID GROUP NO.
P00683616OtherSCRR MEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070316000164 SC Practitioner - Family Practice 7517060239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Physicians of Spartanburg, PCGroup PAC ID 2961561568, 10 clinicians

Practice addresses (Care Compare)

3021 Reidville Rd
Spartanburg, SC 29301-5643
Phone (864) 576-9201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9525SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physicians of Spartanburg, PC Family Medicine CurrentSince Oct 20, 2008 Accepting new patients
Mary Black Physicians Group LLC Family Medicine Past Accepting new patients

Locations

3021 Reidville Rd
Spartanburg, SC 29301
Phone (864) 576-9201

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAJFAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GAJFAA/Endpoint/GAJFAA
  • Direct secure messaging: lee.taylor@fpos.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 48

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1003863929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015643",
            "telephone_number": "864-576-9201",
            "fax_number": "864-576-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015643",
            "telephone_number": "864-576-9201",
            "fax_number": "864-576-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LEE",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "9525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095257",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NO.",
            "identifier": "GP4988",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P00683616",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.