Individual provider Active NPI

William Dennis Taylor Jr., MD

  • Geriatric Medicine (Family Medicine) Physician
  • Dublin, GA
National Provider Identifier
1083619670
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
033213 Issued in GA
Practice address
160 Spring Branch Dr
Dublin, GA 31021-0356
Phone
(478) 274-8489
NPI assigned
Jun 20, 2005
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 033213 GA Primary

Addresses

Primary practice location

160 Spring Branch Dr
Dublin, GA 31021-0356

Mailing address

160 Spring Branch Dr
Dublin, GA 31021-0356
Phone (478) 274-8489

Other identifiers 1

IdentifierTypeStateIssuer
000443748CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040426000093 GA Practitioner - Geriatric Medicine 8022004829 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
033213GAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Geriatrics Inc CurrentSince Jul 7, 1997 Accepting new patients
Transitional Care Physicians of Georgia PC CurrentSince Aug 1, 2020 Accepting new patients
Chronic Disease Management of Georgia, LLC CurrentSince Aug 1, 2020 Accepting new patients
Geriatric Ancillary Services Inc Past Accepting new patients

Locations

704 Breedlove Dr
#A
Monroe, GA 30655
Phone (888) 772-0076

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1083619670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SPRING BRANCH DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210356",
            "telephone_number": "478-274-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 SPRING BRANCH DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210356",
            "telephone_number": "478-274-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "WILLIAM",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "033213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000443748C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.