Individual provider Active NPI

Cathy Ann Taylor, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spring, TX
National Provider Identifier
1063196236
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1123558 Issued in TX
Practice address
22325 Gosling Rd
Spring, TX 77389-4409
Phone
(210) 724-7980
Fax
(281) 547-7911
NPI assigned
Jun 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 978629 TX
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 1123558 TX Primary

Addresses

Primary practice location

22325 Gosling Rd
Spring, TX 77389-4409

Mailing address

22325 Gosling Rd
Spring, TX 77389-4409
Phone (210) 724-7980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230918002158 TX Practitioner - Nurse Practitioner 7618331026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Magnolia Management LLCGroup PAC ID 7810391984, 19 clinicians

Practice addresses (Care Compare)

13145 Spring Cypress Rd
Cypress, TX 77429-2004
Phone (281) 724-7980

1904 Longmire Rd
Suite 401
Conroe, TX 77304-5024
Phone (281) 724-7980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
978629TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Magnolia Management LLC Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Ideal Psychiatry PLLC Single Specialty Current Accepting new patients

Locations

1904 Longmire Rd
Ste 401
Conroe, TX 77304

13145 Spring Cypress Rd
Cypress, TX 77429

22325 Gosling Rd
Spring, TX 77389

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1063196236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22325 GOSLING RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894409",
            "telephone_number": "210-724-7980",
            "fax_number": "281-746-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22325 GOSLING RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894409",
            "telephone_number": "210-724-7980",
            "fax_number": "281-547-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CATHY",
        "middle_name": "ANN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "978629",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1123558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.