Individual provider Active NPI

Thomas Matthew Taylor, FNP- BC

  • Family Nurse Practitioner
  • Fulton, MS
National Provider Identifier
1093040057
Registry record updated Feb 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R869922 Issued in MS
Practice address
1 Medical Park Dr
Fulton, MS 38843-9001
Phone
(662) 862-5200
Fax
(662) 862-5297
NPI assigned
Oct 8, 2009
Last updated
Feb 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R869922 MS Primary

Addresses

Primary practice location

1 Medical Park Dr
Fulton, MS 38843-9001

Mailing address

1 Medical Park Dr
Fulton, MS 38843-9001
Phone (662) 862-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100608000758 MS Practitioner - Nurse Practitioner 7719017326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Park Dr
Fulton, MS 38843-9001
Phone (662) 862-5200

845 S Madison
Tupelo, MS 38801-4905
Phone (601) 790-5025

860 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-7150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Family Current Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Jul 1, 2010 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Jul 1, 2010 Accepting new patients
North Mississippi Medical Clinics Inc Past Accepting new patients

Locations

1 Medical Park Dr
Fulton, MS 38843
Phone (662) 862-5200

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

844 S Madison St
Ste A
Tupelo, MS 38801

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

903 Mississippi Dr
Tupelo, MS 38804
Phone (662) 377-4652

Interoperability endpoints

  • Direct secure messaging: thomastaylor@nmhs.medalliesdirect.net

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 2

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": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298678400000",
    "number": "1093040057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388439001",
            "telephone_number": "662-862-5200",
            "fax_number": "662-862-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388439001",
            "telephone_number": "662-862-5200",
            "fax_number": "662-862-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "THOMAS",
        "middle_name": "MATTHEW",
        "credential": "FNP- BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-08",
        "last_updated": "2011-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R869922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MS

Sources for this page

Verify at the official NPI Registry.