Sean Paul Taylor, CERTIFIED PROSTETIST

Key facts

NPI

1083864342

Entity type

Individual (NPI type 1)

Primary specialty

Customized Equipment (DME) 332BC3200X

License

CP003634 (NE)

Practice address

3318 Gold Dust St NE
Belmont, MI 49306-9157

Phone

(616) 490-8564

NPI assigned

Sep 23, 2008

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Laker Prosthetics Prosthetist · Grand Rapids, MI · NPI 1154894046
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 13, 2016.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1083864342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 GOLD DUST ST NE",
            "city": "BELMONT",
            "state": "MI",
            "postal_code": "493069157",
            "telephone_number": "616-490-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 GOLD DUST ST NE",
            "city": "BELMONT",
            "state": "MI",
            "postal_code": "493069157",
            "telephone_number": "616-490-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SEAN",
        "middle_name": "PAUL",
        "credential": "CERTIFIED PROSTETIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NE",
            "license": "CP003634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MI

• Jessica Ann Skinner, LMSW
• Robin Skrbina, CCC-SLP
• Spectrum Health Primary Care Partners
• Sarah Spurgeon, RN
• Charla Lee Sweat, RRT, LMT
• Telebehavioral Health US
• Chad Tener, RN
• Trilogy Healthcare of Belmont, LLC
• True Sleep Center LLC
• Tyler Truxton

All providers in Belmont, MI · Customized Equipment (DME) in Michigan