Active NPI
David O. Taylor, M.D.
- Psychiatry Physician
- Goshen, IN
National Provider Identifier
1184623027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01043934A
- Practice address
- 330 Lakeview Dr
Goshen, IN 46528-9365 - Phone
- (574) 533-1234
- Fax
- (574) 537-2652
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- No
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Elkhart, IN
- NPI 1598847212
IN
-
- Psychiatric Hospital
- Goshen, IN
- NPI 1467407395
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- West Virginia University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oaklawn Psychiatric Center Inc
Practice addresses (Care Compare)
330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100129000404 | IN | Practitioner - Psychiatry | 8729121736 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01043934A | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oaklawn Psychiatric Center, Inc. | Current | Accepting new patients | |
| Oaklawn Psychiatric Center, Inc. | Current | Accepting new patients | |
| Elkhart General Hospital, Inc. | Past | Accepting new patients |
Locations
2600 Oakland Ave
Elkhart, IN 46517
Phone 5745331234 ext. 488
330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01043934A | IN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
330 Lakeview Dr
Goshen, IN 46528-9365
Mailing address
330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234
Other identifiers 2
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200082620A | Medicaid | IN | |
| 000000109321 | Other | IN | ANTHEM BCBS |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2015.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1184623027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 LAKEVIEW DR",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465289365",
"telephone_number": "574-533-1234",
"fax_number": "574-537-2652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 LAKEVIEW DR",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465289365",
"telephone_number": "574-533-1234",
"fax_number": "574-537-2652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "DAVID",
"middle_name": "O.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01043934A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200082620A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000109321",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.