Individual provider Active NPI

Taylor Marie Shank, PH.D.

  • Psychologist
  • Meadville, PA
National Provider Identifier
1013442490
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS020345 Issued in PA
Practice address
18201 Conneaut Lake Rd
Meadville, PA 16335-3757
Phone
(814) 333-5061
Fax
(814) 333-5067
NPI assigned
Apr 24, 2017
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS020345 PA Primary

Addresses

Primary practice location

18201 Conneaut Lake Rd
Meadville, PA 16335-3757

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5061

Other practice location 1

765 Liberty St Ste 202
Meadville, PA 16335-2568
Phone (814) 333-5888

Other names 1

  • Taylor Marie Proper Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331001162 PA Practitioner - Clinical Psychologist 4385167410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadville Medical CenterGroup PAC ID 4284535790, shared by 20 NPIs, 139 clinicians

Practice addresses (Care Compare)

18201 Conneaut Lake Rd
Meadville, PA 16335-3757
Phone (814) 333-5060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Medical Center Current Accepting new patients
Meadville Medical Center Psychologist CurrentSince Jan 25, 2025 Accepting new patients
Meadville Medical Center CurrentSince Jan 25, 2025 Accepting new patients
Meadville Medical Center CurrentSince Jan 25, 2025 Accepting new patients
Pacific University Past Accepting new patients

Locations

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

18201 Conneaut Lake Rd
Meadville, PA 16335
Phone (814) 333-5060

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

765 Liberty St
Ste 202
Meadville, PA 16335
Phone (814) 333-5888

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1013442490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18201 CONNEAUT LAKE RD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353757",
            "telephone_number": "814-333-5061",
            "fax_number": "814-333-5067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "765 Liberty St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352568",
            "country_code": "US",
            "telephone_number": "814-333-5888",
            "fax_number": "814-333-5887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANK",
        "first_name": "TAYLOR",
        "middle_name": "MARIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS020345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "PROPER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.