Organization Active NPI

Dawn O Taylor PHD PC

  • Psychologist
  • Boulder, CO
National Provider Identifier
1093896607
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
DAWN O TAYLOR PHD PC
Practice address
3445 Penrose PL Ste 250
Boulder, CO 80301-1877
Phone
(303) 473-4435
Fax
(303) 447-6453
NPI assigned
Oct 18, 2006
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Dr. Dawn O. Taylor, PHDNPI 1043395924
Title
Owner
Phone
(303) 473-4435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

3445 Penrose PL Ste 250
Boulder, CO 80301-1877

Mailing address

3445 Penrose PL Ste 250
Boulder, CO 80301-1877
Phone (303) 473-4435

Other identifiers 1

IdentifierTypeStateIssuer
07007313MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411001363 CO Part B Supplier - Clinic/Group Practice 6002048725 Receives reassigned benefits from 1 practitioner
Practice locations: Boulder, CO

National Provider Directory

National Provider Directory

Locations

3445 Penrose Pl
Ste 250
Boulder, CO 80301
Phone (303) 473-4435

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1093896607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL STE 250",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011877",
            "telephone_number": "303-473-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 PENROSE PL STE 250",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011877",
            "telephone_number": "303-473-4435",
            "fax_number": "303-447-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN O TAYLOR PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-473-4435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07007313",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.