Tara Leigh Taylor, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004211 Issued in MI

Practice address

6770 Dixie Hwy Ste 314
Clarkston, MI 48346-5114

Phone

(248) 762-5820

Fax

(888) 375-2104

NPI assigned

Aug 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tara Leigh Strom Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peyton and Davenport, IncGroup PAC ID 0648312421, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Peyton & Davenport, Inc

  • Psychologist
  • Clarkston, MI
  • NPI 1518291806
  Medicare reassignment Care Compare group
• Flushing Urgent Care PLC

  • Urgent Care Clinic/Center
  • Flushing, MI
  • NPI 1780930016
  NPD
• Barber Co

  • Internal Medicine Physician
  • Highland, MI
  • NPI 1649490723
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1154512374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY STE 314",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465114",
            "telephone_number": "248-762-5820",
            "fax_number": "888-375-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 DIXIE HWY STE 314",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465114",
            "telephone_number": "248-762-5820",
            "fax_number": "888-375-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TARA",
        "middle_name": "LEIGH",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "TT004211",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "TT004211",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "STROM",
            "middle_name": "LEIGH",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew Tarockoff, MA, LPC
• Abigail Christine Taylor
• Brian Taylor, LMSW
• Kathleen Marie Taylor, LLMSW
• Rachel Lynn Taylor, LMSW
• Haley Lynn Teenier
• Jessica Leigh Teeples
• Tender Loving Care Health Care Services of Michigan, L.L.C.
• Emily Tenniswood, LMSW
• Sarah Maria Tereau, AGPCNP

• Physician Assistant in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.