Active NPI
Deanthony James Taylor, PARAMEDIC
- Paramedic
- Fort Campbell, KY
National Provider Identifier
1083581482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Paramedic
- License
- M5140316
- Practice address
- 7973 W Destiny Blvd
Fort Campbell, KY 42223-5429 - Phone
- (270) 697-0011
- NPI assigned
- Oct 20, 2025
- Last updated
- Oct 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | M5140316 | VA | Primary |
Addresses
Primary practice location
7973 W Destiny Blvd
Fort Campbell, KY 42223-5429
Mailing address
99 Michigan Ave
Fort Campbell, KY 42223-5614
Phone (270) 697-0011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5140316 | VA | MD | Paramedic |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760918400000",
"number": "1083581482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 MICHIGAN AVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235614",
"telephone_number": "270-697-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7973 W DESTINY BLVD",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235429",
"telephone_number": "270-697-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "DEANTHONY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PARAMEDIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-20",
"last_updated": "2025-10-20",
"certification_date": "2025-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "146L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medical Technician, Paramedic",
"state": "VA",
"license": "M5140316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.