Individual provider Active NPI

Jean A Taylor, RN CDOE

  • Diabetes Educator Registered Nurse
  • Providence, RI
National Provider Identifier
1104351717
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
RN25956 Issued in RI
Practice address
300 Richmond St
Providence, RI 02903-4222
Phone
(401) 430-2000
Fax
(401) 453-7597
NPI assigned
Apr 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN25956 RI Primary

Addresses

Primary practice location

300 Richmond St
Providence, RI 02903-4222

Mailing address

300 Richmond St
Providence, RI 02903-4222
Phone (401) 430-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN25956RIMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1104351717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RICHMOND ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034222",
            "telephone_number": "401-430-2000",
            "fax_number": "401-453-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RICHMOND ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034222",
            "telephone_number": "401-430-2000",
            "fax_number": "401-453-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JEAN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN CDOE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "RI",
            "license": "RN25956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.