Individual provider Active NPI

Jordan Taylor

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1053989533
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
200 Patewood Dr Ste C250
Greenville, SC 29615-3593
Phone
(864) 780-4793
Fax
(864) 794-5409
NPI assigned
Jun 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X SC
Physical Therapist 225100000X Primary

Addresses

Primary practice location

200 Patewood Dr Ste C250
Greenville, SC 29615-3593

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

2175 E 11th St
Loveland, CO 80537-3238
Phone (970) 593-9300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mail@one80pt.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12346SCMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mail@one80pt.com

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1053989533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-780-4793",
            "fax_number": "864-794-5409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2175 E 11th St",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805373238",
            "country_code": "US",
            "telephone_number": "970-593-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mail@one80pt.com",
            "affiliation": "N",
            "address_1": "2175 E 11th St",
            "city": "Loveland",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805373238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.