Marilyn Sue Taylor, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

477 Issued in OK

Practice address

9500 N 129TH East Ave
Owasso, OK 74055-5378

Phone

(918) 858-4353

Fax

(866) 246-2942

NPI assigned

Feb 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metabolic Centers for Excellence LLCGroup PAC ID 1557883162, 5 clinicians

Practice addresses (Care Compare)

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.

• Prophylaxis Healthcare LLC

  • Multi-Specialty Clinic/Center
  • Bixby, OK
  • NPI 1538453923
  Medicare reassignment NPD
• Metabolic Centers for Excellence LLC

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1518772755
  Care Compare group
• Hatton Anesthesia LLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1659922201
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663977600000",
    "number": "1063485316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268838",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268838",
            "telephone_number": "918-660-3632",
            "fax_number": "918-660-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 N 129TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555378",
            "telephone_number": "918-858-4353",
            "fax_number": "866-246-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARILYN",
        "middle_name": "SUE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100197730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Tabor
• Breonna Tallman
• Cynthia D Taylor, PT
• Cynthia M Taylor, CSFA
• David Taylor
• Ryan Taylor
• Victoria Grace Taylor
• Taylors Surgical Assisting LLC
• Tera Egleston Chiropractic Clinic PC
• Susan Renee Terhune, LPC

• Physician Assistant in Owasso, OK
• Providers in Owasso, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.