Tavis J Taylor, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00030507 Issued in WA

Practice address

3036 Perry Ave
Suite a
Bremerton, WA 98310-5349

Phone

(360) 627-8493

Fax

(360) 627-7920

NPI assigned

Oct 4, 2005

Last updated

Apr 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Internal Medicine

Education

University of Washington School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

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.

• Franciscan Medical Group

  dba Franciscan Orthopedics-Silverdale

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment Care Compare group NPD
• Pacmed Clinics

  dba Pacific Medical Centers

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1013061217

  Internal Medicine

  Medicare reassignment NPD
• Eagle Sweep Integrative Internal Medicine Incorporated

  • Internal Medicine Physician
  • Bremerton, WA
  • NPI 1780906255
  Authorized official Same address or phone
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421

  Internal Medicine

  NPD
• Franciscan Medical Group

  dba The Doctors Clinic, A Part of the Franciscan Medical Group

  • Internal Medicine Physician
  • Silverdale, WA
  • NPI 1710432612
  NPD
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1720023641
  NPD
• Franciscan Medical Group

  dba Franciscan Medical Clinic-Gig Harbor

  • Family Medicine Physician
  • Gig Harbor, WA
  • NPI 1386602555
  NPD (past)
• Integra Imaging, PS

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1205189461
  NPD (past)
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Bothell, WA
  • NPI 1588103451

  Internal Medicine

  NPD (past)
• Port Gamble S'Klallam Tribe

  dba Tribal Medicaid FQHC

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1518585579
  NPD (past)
• Port Gamble S'Klallam Tribe

  dba Port Gamble S'Klallam Health Center

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1760428650
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1043207020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3036 PERRY AVE",
            "address_2": "SUITE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983105349",
            "telephone_number": "360-627-8493",
            "fax_number": "360-627-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 PERRY AVE",
            "address_2": "SUITE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983105349",
            "telephone_number": "360-627-8493",
            "fax_number": "360-627-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TAVIS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00030507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8241556",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS HEALTHPLANS",
            "identifier": "263080490",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "91114366598310A009",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "128813",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS HEALTHPLANS",
            "identifier": "91114366509",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "TA7118",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttaylor878567@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "220 15th Ave SE Ste C",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983723797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karli Rose Taylor
• Kimberly A Taylor, RPH
• Maureen Taylor, LPN
• Patricia A Taylor, RN
• Stephen Zachary Taylor, IDC
• Trinity Taylor
• Tyshawn Taylor
• Michael W Tebow, LFMT
• Shawn Erik Tedford, PA-C
• Bryce Isaiah Templeman, PA-C

• Internal Medicine Physician in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.