Individual provider Active NPI

Kristi A Taylor, WHCNP

  • Women's Health Nurse Practitioner
  • Medford, OR
National Provider Identifier
1083156277
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
202007158NP-PP Issued in OR
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
500784776MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019000742 OR Practitioner - Nurse Practitioner 5092070649 Reassigns benefits to 2 organizations

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

LicenseStateTypeSpecialty
202007158NP-PPORMDWomen's Health Nurse Practitioner
0024176944VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Oct 15, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 15, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 15, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 15, 2020 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.