Flynn A Taylor I, M.D.
Individual provider Active NPI Family Medicine Physician · Deridder, LA
NPI 1174585897 · NPPES record last updated Sep 15, 2014
Key facts
- NPI
- 1174585897
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 014367 (LA)
- Practice address
- 501 S Pine St
Deridder, LA 70634-4939 - Phone
- (337) 463-9890
- Fax
- (337) 462-9521
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Saint Louis University School of Medicine, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1332 Blankenship Dr
Deridder, LA 70634-4939
501 S Pine St
Deridder, LA 70634-4939
Hospital & facility affiliations
- Beauregard Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100622000180 | LA | Practitioner - Family Practice | 3779614615 |
Reassigns benefits to 1 organization Practice locations: Deridder, LA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beauregard Family Medical Center, LLC | Current |
Accepting new patients |
Locations
501 S Pine St
Deridder, LA 70634
Phone (337) 462-3937
501 S Pine St
#C
Deridder, LA 70634
Phone (337) 463-9890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 014367 | LA | Yes |
Addresses
Primary practice location
501 S Pine St
Deridder, LA 70634-4939
Mailing address
501 S Pine St
Deridder, LA 70634-4939
Phone (337) 463-9890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014367 | Other | LA | STATE LICENSE NUMBER |
| 1186384 | Medicaid | LA |
Other providers in Deridder, LA
- Sherrie McDaniel Strother
- Robbie Suire
- Matthew Lee Sykes
- Dorothy Annette Syzdek
- Alexandra Takagishi
- The Big Pink Barn LLC
- The Foot Clinic of West Louisiana
- The Perkins Pediatric Clinic, LLC
- Terri Theaux
- Adrienne D Thibodeau
All providers in Deridder, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.