Active NPI
Kristi A Taylor, WHCNP
- Women's Health Nurse Practitioner
- Medford, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 202007158NP-PP
- Practice address
- 1698 E McAndrews Rd Ste 400
Medford, OR 97504-5590 - Phone
- (541) 732-7400
- NPI assigned
- Nov 5, 2016
- Last updated
- Jan 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 202007158NP-PP | OR | Primary |
| Women's Health Nurse Practitioner | 363LW0102X | 0024176944 | VA |
Addresses
Primary practice location
1698 E McAndrews Rd Ste 400
Medford, OR 97504-5590
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (541) 732-7400
Other practice location 1
505 Oakfield Dr
Brandon, FL 33511-5700
Phone (813) 684-2229
Other practice location 2
12706 McManus Blvd
Newport News, VA 23602
Phone (757) 874-2229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500784776 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ktaylor1405208@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
940 Royal Ave
Unit 350
Medford, OR 97504-6194
Phone (541) 732-7460
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202007158NP-PP | OR | MD | Women's Health Nurse Practitioner |
| 0024176944 | VA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients |
Locations
1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250
1698 E McAndrews Rd
Ste 400
Medford, OR 97504
Phone (541) 732-6000
940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460
Organizations & group practices 5
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.
-
dba Providence Medical Group South
- Family Medicine Physician
- Medford, OR
- NPI 1568547503
-
dba Providence Medford Medical Center
- Clinic/Center
- Medford, OR
- NPI 1093976243
-
dba Providence Medford Medical Center
- Clinical Pathology Physician
- Medford, OR
- NPI 1285185942
-
dba PMG Eagle Point Pediatrics
- Clinic/Center
- Eagle Point, OR
- NPI 1922481456
-
dba Providence Medical Group South
- Clinic/Center
- Phoenix, OR
- NPI 1992882500
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Medford Medical Center
- General Acute Care Hospital
- Medford, OR
- NPI 1689755670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1083156277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "541-732-7400",
"fax_number": "757-874-7525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1698 E MCANDREWS RD STE 400",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975045590",
"telephone_number": "541-732-7400"
}
],
"practiceLocations": [
{
"address_1": "505 Oakfield Dr",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335115700",
"country_code": "US",
"telephone_number": "813-684-2229",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12706 McManus Blvd",
"address_purpose": "LOCATION",
"city": "Newport News",
"state": "VA",
"postal_code": "23602",
"country_code": "US",
"telephone_number": "757-874-2229",
"fax_number": "757-874-7525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAYLOR",
"first_name": "KRISTI",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-05",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OR",
"license": "202007158NP-PP",
"primary": true
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "VA",
"license": "0024176944",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500784776",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ktaylor1405208@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1698 E McAndrews Rd Ste 400",
"city": "Medford",
"state": "OR",
"country_code": "US",
"postal_code": "975045590",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.