Individual provider Active NPI

James Bradford Taylor, PA

  • Physician Assistant
  • Raeford, NC
National Provider Identifier
1194962217
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01651 Issued in NC
Practice address
1090 E Central Ave
Raeford, NC 28376-3039
Phone
(910) 875-4545
Fax
(910) 875-8972
NPI assigned
Jan 12, 2009
Last updated
Aug 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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 0010-01651 NC Primary

Addresses

Primary practice location

1090 E Central Ave
Raeford, NC 28376-3039

Mailing address

1090 E Central Ave
Raeford, NC 28376-3039
Phone (910) 875-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20110208000240 NC Practitioner - Physician Assistant 5597945642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longleaf Wellness PLLCGroup PAC ID 3072844836, 2 clinicians

Practice addresses (Care Compare)

1090 E Central Ave
Raeford, NC 28376-3039
Phone (910) 875-4545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-01651NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: longleafwellnesspllc.jamestaylor@143442.advancedmd-direct.com

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.

Hospital & facility affiliations 4

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": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1194962217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 E CENTRAL AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763039",
            "telephone_number": "910-875-4545",
            "fax_number": "910-875-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 E CENTRAL AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763039",
            "telephone_number": "910-875-4545",
            "fax_number": "910-875-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JAMES",
        "middle_name": "BRADFORD",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.