Individual provider Active NPI

Keith Allen Taylor Jr., D.C.

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1114027729
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10164 Issued in TX
Practice address
6207 Pecan Valley Dr
San Antonio, TX 78223-3226
Phone
(210) 359-9100
Fax
(210) 333-6884
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10164 TX Primary

Addresses

Primary practice location

6207 Pecan Valley Dr
San Antonio, TX 78223-3226

Mailing address

6207 Pecan Valley Dr
San Antonio, TX 78223-3226
Phone (210) 359-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110916000371 TX Practitioner - Chiropractic 6507037892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4501 McCullough Ave
Suite 107
San Antonio, TX 78212-1659
Phone (210) 828-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KT Health Management Service LLC Chiropractor CurrentSince Apr 19, 2023 Accepting new patients

Locations

4501 McCullough Ave
Ste 107
San Antonio, TX 78212
Phone (210) 828-9211

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1114027729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 PECAN VALLEY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233226",
            "telephone_number": "210-359-9100",
            "fax_number": "210-333-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6207 PECAN VALLEY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233226",
            "telephone_number": "210-359-9100",
            "fax_number": "210-333-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.