Individual provider Active NPI

Taylor Osborn, DO

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1114711744
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11024087A Issued in IN
Practice address
5230 E Stop 11 Rd Ste 250
Indianapolis, IN 46237-6399
Phone
(317) 528-8921
Fax
(317) 528-6916
NPI assigned
Apr 8, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11024087A IN Primary

Addresses

Primary practice location

5230 E Stop 11 Rd Ste 250
Indianapolis, IN 46237-6399

Mailing address

PO Box 781008
Detroit, MI 48278-1008
Phone (317) 528-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701002192 IN Order and Referring Only - Family PracticePractitioner - Family Practice 2769995968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
11024087AINMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1114711744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781008",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781008",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 E STOP 11 RD STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376399",
            "telephone_number": "317-528-8921",
            "fax_number": "317-528-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "TAYLOR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11024087A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.