NPIMap

Organization Active NPI

Taylor Internal Medicine of Selma, P.C.

  • Specialist
  • Selma, AL
National Provider Identifier
1114013315
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24464 Issued in AL
Legal business name
TAYLOR INTERNAL MEDICINE OF SELMA, P.C.
Practice address
4258 US Highway 80 W
Selma, AL 36701-2202
Phone
(334) 874-8800
Fax
(334) 874-7700
NPI assigned
Oct 5, 2006
Last updated
Jan 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Bruce Edward Taylor, M.D.NPI 1760410849
Title
Physician
Phone
(334) 874-8800

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
Specialist 174400000X 24464 AL Primary

Addresses

Primary practice location

4258 US Highway 80 W
Selma, AL 36701-2202

Mailing address

4258 US Highway 80 W
Selma, AL 36701-2202
Phone (334) 874-8800

Other identifiers 1

IdentifierTypeStateIssuer
529916810MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050822001007 AL Part B Supplier - Clinic/Group Practice 9537190350 Receives reassigned benefits from 2 practitioners
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

4258 US Highway 80 W
Selma, AL 36701
Phone (334) 874-8800

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1114013315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4258 US HIGHWAY 80 W",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367012202",
            "telephone_number": "334-874-8800",
            "fax_number": "334-874-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4258 US HIGHWAY 80 W",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367012202",
            "telephone_number": "334-874-8800",
            "fax_number": "334-874-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR INTERNAL MEDICINE OF SELMA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "334-874-8800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "24464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529916810",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.