Active NPI
Elmo Lee Taylor, PAC
- Physician Assistant
- Clinton, UT
National Provider Identifier
1114023124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1025541206
- Practice address
- 1477 North 2000 West
Westside Medical
Clinton, UT 84015 - Phone
- (801) 774-8888
- Fax
- (801) 825-8519
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1025541206 | UT | Primary |
Addresses
Primary practice location
1477 North 2000 West
Westside Medical
Clinton, UT 84015
Mailing address
1477 North 2000 West
Westside Medical
Clinton, UT 84015
Phone (801) 774-8888
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255392000000",
"number": "1114023124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1477 NORTH 2000 WEST",
"address_2": "WESTSIDE MEDICAL",
"city": "CLINTON",
"state": "UT",
"postal_code": "84015",
"telephone_number": "801-774-8888",
"fax_number": "801-825-8519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1477 NORTH 2000 WEST",
"address_2": "WESTSIDE MEDICAL",
"city": "CLINTON",
"state": "UT",
"postal_code": "84015",
"telephone_number": "801-774-8888",
"fax_number": "801-825-8519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "ELMO",
"middle_name": "LEE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2009-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "1025541206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.