Active NPI
Henry J Taylor III, MD
- Family Medicine Physician
- Copalis Beach, WA
National Provider Identifier
1194795906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-065592
- Practice address
- 3010 State Route 109
Copalis Beach, WA 98535-0339 - Phone
- (360) 289-2427
- Fax
- (360) 289-9982
- NPI assigned
- Jan 24, 2006
- Last updated
- Oct 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-065592 | OH | Primary |
Addresses
Primary practice location
3010 State Route 109
Copalis Beach, WA 98535-0339
Mailing address
PO Box 34703
Seatle, WA 98124-1703
Phone (206) 764-3335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0945 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-065592 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylor Mobile Med | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1194795906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34703",
"city": "SEATLE",
"state": "WA",
"postal_code": "981241703",
"telephone_number": "206-764-3335",
"fax_number": "206-764-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 STATE ROUTE 109",
"city": "COPALIS BEACH",
"state": "WA",
"postal_code": "985350339",
"telephone_number": "360-289-2427",
"fax_number": "360-289-9982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "HENRY",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35-065592",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0945",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Copalis Beach, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.