Taylor Kane Rickenbaker, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110007929 Issued in VA

Practice address

144 S Gum Ave
Virginia Beach, VA 23452-1221

Phone

(229) 291-1727

NPI assigned

Mar 15, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Taylor Kane Jacobson Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Chesapeake Hospital Authority

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1003265075
  Care Compare affiliation
• Chesapeake Hospital Authority

  • Pharmacy
  • Chesapeake, VA
  • NPI 1558466318

  Hospital

  Care Compare affiliation
• Chesapeake Hospital Authority

  • General Acute Care Hospital
  • Chesapeake, VA
  • NPI 1700896354
  Care Compare affiliation

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1033450010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S GUM AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521221",
            "telephone_number": "229-291-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 S GUM AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521221",
            "telephone_number": "229-291-1727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "397 Little Neck Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234525774",
            "country_code": "US",
            "telephone_number": "757-395-1600",
            "fax_number": "757-961-9359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKENBAKER",
        "first_name": "TAYLOR",
        "middle_name": "KANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110007929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "JACOBSON",
            "middle_name": "KANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Beatrice Richardson
• Quincy Lee Richardson
• Karen Michelle Richendollar, MSN, APRN, PMHNP-BC,
• Leslie I Richmond, DDS
• Catherine H Richwine, RPH.
• Tyrone O Rickey, RPH
• Allison Ricks
• Kelsey Ricks, MA, BCBA, LBA
• Maeoni Ricks
• Renisha Ricks

• Surgical Physician Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.