Individual provider Active NPI

Tyra Lynn Taylor, NP

  • Women's Health Nurse Practitioner
  • Union, SC
National Provider Identifier
1174920847
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
19181 Issued in SC
Practice address
1201 Furman L Fendley Hwy Ste C
Union, SC 29379-7419
Phone
(864) 427-8380
Fax
(864) 427-8308
NPI assigned
Nov 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 19181 SC Primary

Addresses

Primary practice location

1201 Furman L Fendley Hwy Ste C
Union, SC 29379-7419

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 1

IdentifierTypeStateIssuer
NP3008MedicaidSC

Other names 1

  • Tyra L Mason Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ttaylor40723@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150130002397 SC Practitioner - Nurse Practitioner 6204150881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Medical CenterGroup PAC ID 2264749308, 14 clinicians

Practice addresses (Care Compare)

1201 Furman L Fendley Hwy
Suite C
Union, SC 29379-7419
Phone (864) 427-8380

Hospital & facility affiliations

  • Union Medical Center Hospital, Union, SC, CCN 420108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19181SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Union Medical Center CurrentSince Jun 1, 2025 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Union Medical Center CurrentSince Jun 1, 2025 Accepting new patients
Union Medical Center Current Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

2 Maple Tree Ct
Ste B
Greenville, SC 29615
Phone (864) 297-8777

1201 Furman L Fendley Hwy
Ste C
Union, SC 29379
Phone (864) 427-8380

Organizations & group practices 10

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 1

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1174920847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FURMAN L FENDLEY HWY STE C",
            "city": "UNION",
            "state": "SC",
            "postal_code": "293797419",
            "telephone_number": "864-427-8380",
            "fax_number": "864-427-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TYRA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "19181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3008",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttaylor40723@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ttaylor40723@direct-srhs.et0939.epichosted.com",
            "address_1": "1201 Furman L Fendley Hwy Ste C",
            "city": "Union",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293797419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TYRA",
            "last_name": "MASON",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Union, SC

Sources for this page

Verify at the official NPI Registry.