Individual provider Active NPI

Jennifer Elizabeth Taylor, DO

  • Surgery Physician
  • Decatur, IN
National Provider Identifier
1093079923
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
02005062A Issued in IN
Practice address
1100 Mercer Ave
Decatur, IN 46733-2303
Phone
(260) 724-2145
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101019750 MI
Surgery Physician 208600000X 02005062A IN Primary

Addresses

Primary practice location

1100 Mercer Ave
Decatur, IN 46733-2303

Mailing address

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 724-2145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170628001314 IN Practitioner - General Surgery 0648580878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams County Memorial HospitalGroup PAC ID 0941198253, 85 clinicians

Practice addresses (Care Compare)

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 724-2145

Hospital & facility affiliations

  • Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy80
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux113
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth14
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019750MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Memorial Hospital CurrentSince May 23, 2017 Accepting new patients
Adams County Memorial Hospital CurrentSince May 23, 2017 Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

Interoperability endpoints

  • Direct secure messaging: jtaylor130738@direct.parkviewexchange.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1093079923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "260-724-2145",
            "fax_number": "260-728-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MERCER AVE",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332303",
            "telephone_number": "260-724-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101019750",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "02005062A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

Verify at the official NPI Registry.