Individual provider Active NPI

Jessica Ann Taylor, PA-C

  • Physician Assistant
  • Overland Park, KS
National Provider Identifier
1184851776
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-01442 Issued in KS
Practice address
10116 W 105TH St
Overland Park, KS 66212-5746
Phone
(913) 541-0510
Fax
(913) 541-1852
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-01442 KS Primary

Addresses

Primary practice location

10116 W 105TH St
Overland Park, KS 66212-5746

Mailing address

10116 W 105TH St
Overland Park, KS 66212-5746
Phone (913) 541-0510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20110628000886 KS Practitioner - Physician Assistant 4880748235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Associates LLCGroup PAC ID 1759305931, 13 clinicians

Practice addresses (Care Compare)

10116 W 105TH St
Overland Park, KS 66212-5746
Phone (913) 495-9600

Hospital & facility affiliations

  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Past Accepting new patients

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.

Hospital & facility affiliations 2

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1184851776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 W 105TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125746",
            "telephone_number": "913-541-0510",
            "fax_number": "913-541-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 W 105TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125746",
            "telephone_number": "913-541-0510",
            "fax_number": "913-541-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.