Individual provider Active NPI

Tawanda Taylor, CRNP

  • Adult Health Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1124413661
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-115111 Issued in AL
Practice address
3065 Dauphin St
Mobile, AL 36606-4040
Phone
(251) 271-7017
Fax
(251) 220-5536
NPI assigned
Apr 1, 2015
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-115111 AL Primary

Addresses

Primary practice location

3065 Dauphin St
Mobile, AL 36606-4040

Mailing address

PO Box 746063
Atlanta, GA 30374-6063
Phone (312) 733-9730

Other practice location 1

25806 Pollard Rd Apt 37
Daphne, AL 36526-5175
Phone (251) 850-7034

Other practice location 2

1687 Center Point Pkwy
Birmingham, AL 35215-5528
Phone (205) 557-7022

Other practice location 3

633 Tuscaloosa Ave SW
Birmingham, AL 35211-1637
Phone (205) 235-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150520001273 AL Practitioner - Nurse Practitioner 0547580227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Alabama, LLCGroup PAC ID 9133538432, 28 clinicians

Practice addresses (Care Compare)

3065 Dauphin St
Mobile, AL 36606-4040
Phone (251) 271-7017

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-115111ALMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC CurrentSince Nov 1, 2021 Accepting new patients
Monogram Health Professional Services PC CurrentSince Nov 1, 2021 Accepting new patients
Oak Street Health Physicians Group of Alabama, LLC CurrentSince Mar 28, 2022 Accepting new patients

Locations

1687 Center Point Pkwy
Ste 121
Birmingham, AL 35215
Phone (205) 557-7022

2700 Corporate Dr
Ste 200
Birmingham, AL 35242
Phone (205) 314-4760

633 Tuscaloosa Ave SW
Birmingham, AL 35211
Phone (205) 235-4003

3065 Dauphin St
Mobile, AL 36606
Phone (251) 271-7017

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1124413661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746063",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746063",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064040",
            "telephone_number": "251-271-7017",
            "fax_number": "251-220-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25806 Pollard Rd Apt 37",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365265175",
            "country_code": "US",
            "telephone_number": "251-850-7034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1687 Center Point Pkwy",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352155528",
            "country_code": "US",
            "telephone_number": "205-557-7022",
            "fax_number": "205-831-2849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "633 Tuscaloosa Ave SW",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352111637",
            "country_code": "US",
            "telephone_number": "205-235-4003",
            "fax_number": "205-941-8071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TAWANDA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-115111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.