NPIMap

Organization Active NPI

Pennissi P. Taylor PH.D,PC

Doing business as The Taylor Clinic

  • Clinical Psychologist
  • Brownwood, TX
National Provider Identifier
1114073830
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
15762 Issued in TX
Legal business name
PENNISSI P. TAYLOR PH.D,PC
Doing business as
The Taylor Clinic
Practice address
205 Center Ave.
Brownwood, TX 76801-2919
Phone
(325) 649-4357
Fax
(325) 646-0919
NPI assigned
Jan 26, 2007
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Dr. Pennissi Patrick Taylor, PH.D.NPI 1194850370
Title
Owner
Phone
(325) 649-4357

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
Clinical Psychologist 103TC0700X 15762 TX Primary

Addresses

Primary practice location

205 Center Ave.
Brownwood, TX 76801-2919

Mailing address

PO Box 1391
Brownwood, TX 76804-1391
Phone (325) 649-4357

Other practice location 1

2005 W Wallace St
San Saba, TX 76877-3928
Phone (325) 649-4357

Other identifiers 2

IdentifierTypeStateIssuer
0007QCOtherTXBCBS
203875OtherTXVALUE OPTIONS INSURANCE

Other names 1

  • The Taylor Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000554 TX Part B Supplier - Clinic/Group Practice 9830094192 Receives reassigned benefits from 1 practitioner
Practice locations: Brownwood, TX; Cisco, TX; Coleman, TX; San Saba, TX

National Provider Directory

National Provider Directory

Locations

205 Center Ave
Brownwood, TX 76801
Phone 32564943570000

309 Conrad Hilton Blvd
Cisco, TX 76437

118 W Pecan St
Ste 413
Coleman, TX 76834

1306 E Washington St
Stephenville, TX 76401
Phone (254) 485-0709

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1114073830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1391",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768041391",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CENTER AVE.",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768012919",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 W Wallace St",
            "address_purpose": "LOCATION",
            "city": "San Saba",
            "state": "TX",
            "postal_code": "768773928",
            "country_code": "US",
            "telephone_number": "325-649-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENNISSI P. TAYLOR PH.D,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PENNISSI",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-649-4357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "15762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0007QC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS INSURANCE",
            "identifier": "203875",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Taylor Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brownwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.