Samuel Taylor, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

022479 Issued in GA

Practice address

677 Church St NE # 125
Marietta, GA 30060

Phone

(770) 793-5913

Fax

(770) 999-2445

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.taylor@gab019.digichart.direct-ci.com

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.

• Airport Clinic Inc

  • Clinic/Center
  • Valdosta, GA
  • NPI 1730354739
  Medicare reassignment NPD
• Azalea Womens Center, PC

  • Specialist
  • Valdosta, GA
  • NPI 1710194097
  Medicare reassignment NPD
• Obhg Georgia, P.C.

  • Obstetrics & Gynecology Physician
  • Athens, GA
  • NPI 1750686838
  Medicare reassignment NPD
• Southern OB GYN Associates P C

  • Obstetrics & Gynecology Physician
  • Valdosta, GA
  • NPI 1801951454
  Medicare reassignment NPD
• Samuel Taylor, M.D.

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Valdosta, GA
  • NPI 1962621995
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1164436788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE # 125",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-5913",
            "fax_number": "770-999-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE # 125",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-793-5913",
            "fax_number": "770-999-2445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Bemiss Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316021445",
            "country_code": "US",
            "telephone_number": "229-242-6677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 Bemiss Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316021445",
            "country_code": "US",
            "telephone_number": "229-242-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "022479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00261049D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staylor344691@directwellstar.org",
            "affiliation": "N",
            "address_1": "677 Church St NE # 125",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Norton Taylor
• Leslie Stapley Taylor, PH.D.
• Lindsay Taylor, OTR/L
• Matthew Taylor, MS, BCBA, LBA
• Patricia Taylor, LMT
• Shelley S Taylor, NP
• Teon Taylor, APRN
• Tiani Taylor, RBT
• Tiffany Taylor, PA
• Troy Dennis Taylor, AGNP-C

• Obstetrics & Gynecology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.