Individual provider Active NPI

Deanthony James Taylor, PARAMEDIC

  • Paramedic
  • Fort Campbell, KY
National Provider Identifier
1083581482
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
M5140316 Issued in VA
Practice address
7973 W Destiny Blvd
Fort Campbell, KY 42223-5429
Phone
(270) 697-0011
NPI assigned
Oct 20, 2025
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ParamedicGroup: 193200000X MULTI-SPECIALTY GROUP 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

LicenseStateTypeSpecialty
M5140316VAMDParamedic

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.

Verify at the official NPI Registry.