Individual provider Active NPI

Michelle Alaina Taylor, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1043369861
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2867 Issued in CO
Practice address
2685 Dublin Blvd
Colorado Springs, CO 80918-1358
Phone
(719) 592-9890
NPI assigned
Jan 10, 2007
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2867 CO Primary

Addresses

Primary practice location

2685 Dublin Blvd
Colorado Springs, CO 80918-1358

Mailing address

2685 Dublin Blvd
Colorado Springs, CO 80918-1358
Phone (719) 592-9890

Other identifiers 1

IdentifierTypeStateIssuer
2867OtherCOLICENSURE, COLORADO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20101018000648 CO Practitioner - Physician Assistant 9739283474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Minnie Hamilton Health Care Center, Inc. Past Accepting new patients

Locations

2685 Dublin Blvd
Colorado Springs, CO 80918
Phone (719) 592-9890

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 328-7971

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1043369861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 DUBLIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181358",
            "telephone_number": "719-592-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 DUBLIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181358",
            "telephone_number": "719-592-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHELLE",
        "middle_name": "ALAINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE, COLORADO",
            "identifier": "2867",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.