Individual provider Active NPI

Kenneth Anderson Taylor, M.D.

  • Diagnostic Radiology Physician
  • San Angelo, TX
National Provider Identifier
1114934452
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L4751 Issued in TX
Practice address
120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone
(325) 658-1511
Fax
(325) 481-2165
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X L4751 TX Primary

Addresses

Primary practice location

120 E Beauregard Ave
San Angelo, TX 76903-5919

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 1

IdentifierTypeStateIssuer
8EX216OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20031107000608 TX Practitioner - Diagnostic Radiology 5092628826 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571
  • Heart of Texas Memorial Hospital Hospital, Brady, TX, CCN 451348
  • Lillian M Hudspeth Memorial Hospital Hospital, Sonora, TX, CCN 451324
  • Ballinger Memorial Hospital Hospital, Ballinger, TX, CCN 451310

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4751TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Radiology Imaging Centers Diagnostic Radiology CurrentSince Jul 28, 2014 Accepting new patients
South Texas Radiology Group PA Diagnostic Radiology CurrentSince Jul 28, 2014 Accepting new patients
Shannon Clinic Diagnostic Radiology CurrentSince Mar 1, 2015 Accepting new patients
Modified Barium Swallow Service, P.a. Diagnostic Radiology Past Accepting new patients

Locations

801 N Bedell Ave
Del Rio, TX 78840
Phone (830) 703-1702

499 10th St
Floresville, TX 78114
Phone (830) 216-7096

1020 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 990-1555

3100 Avenue E
Hondo, TX 78861
Phone (830) 426-7700

1905 E State Highway 97
Jourdanton, TX 78026
Phone (210) 614-9603

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

120 E Harris Ave
San Angelo, TX 76903
Phone (325) 653-6741

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

19010 Stone Oak Pkwy
San Antonio, TX 78258
Phone (210) 575-0355

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

7930 Floyd Curl Dr
Fl 2
San Antonio, TX 78229
Phone (210) 617-9850

8401 Datapoint Dr
Ste 600
San Antonio, TX 78229
Phone (210) 616-7796

6700 W Interstate 10
San Antonio, TX 78201
Phone (210) 575-8289

7950 Floyd Curl Dr
Ste 200
San Antonio, TX 78229
Phone (210) 617-9800

9150 Huebner Rd
Ste 100
San Antonio, TX 78240
Phone (210) 575-0000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

4383 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 617-9400

4411 Medical Dr
San Antonio, TX 78229
Phone (210) 575-4584

5307 Broadway
Ste 110
San Antonio, TX 78209

414 Navarro St
Ste 1502
San Antonio, TX 78205
Phone (210) 271-1883

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

Interoperability endpoints

  • Direct secure messaging: ktaylor6760@shannonhealth.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1114934452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035919",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KENNETH",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L4751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EX216",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.