Individual provider Active NPI

Crystal Dianne Taylor, DO

  • Obstetrics & Gynecology Physician
  • Lee's Summit, MO
National Provider Identifier
1184915753
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2015014688 Issued in MO
Practice address
20 NE Saint Lukes Blvd
Suite 310
Lees Summit, MO 64086-6001
Phone
(816) 282-7809
Fax
(816) 282-7870
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2011019206 MO
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 2015014688 MO Primary

Addresses

Primary practice location

20 NE Saint Lukes Blvd
Suite 310
Lees Summit, MO 64086-6001

Mailing address

20 NE Saint Lukes Blvd Ste 310
Lees Summit, MO 64086-6001
Phone (816) 282-7809

Other practice location 1

5701 W 119th St Ste 225
Overland Park, KS 66209-3721
Phone (913) 601-4020

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228001110 KS Practitioner - Obstetrics/Gynecology 4385956481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physician Services LLCGroup PAC ID 1658500962, 39 clinicians

Practice addresses (Care Compare)

21120 W 152ND St
201 Womens Clinic of Johnson County
Olathe, KS 66061-5307
Phone (912) 491-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2011019206MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-West Physician Services LLC Single Specialty CurrentSince Mar 10, 2023 Accepting new patients
Womens Care Single Specialty Past Accepting new patients
Shawnee Mission Medical Center Inc Past Accepting new patients

Locations

8801 Monrovia St
Ste 200
Lenexa, KS 66215

21120 W 152nd St
Ste 201
Olathe, KS 66061
Phone (913) 266-8928

8901 W 74th St
Ste 100
Shawnee Mission, KS 66204
Phone (913) 491-4020

9301 W 74th St
Ste 325
Shawnee Msn, KS 66204
Phone (913) 384-4990

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1184915753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD STE 310",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-282-7809",
            "fax_number": "816-282-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD",
            "address_2": "SUITE 310",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-282-7809",
            "fax_number": "816-282-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 W 119th St Ste 225",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662093721",
            "country_code": "US",
            "telephone_number": "913-601-4020",
            "fax_number": "816-601-4022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CRYSTAL",
        "middle_name": "DIANNE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011019206",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2015014688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.