NPIMap

Organization Active NPI

Taylor Regional Medical Group

Doing business as Taylor Regional Oncology

  • Hematology & Oncology Physician
  • Campbellsville, KY
National Provider Identifier
1205017464
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
TAYLOR REGIONAL MEDICAL GROUP
Doing business as
Taylor Regional Oncology
Taylor Regional Oncology-Radiation
Practice address
125 Greenbriar Dr
Campbellsville, KY 42718-9616
Phone
(270) 789-6166
Fax
(270) 789-6198
NPI assigned
Nov 16, 2007
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Debra Waldron
Title
Coordinator
Phone
(270) 465-3561

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X KY Primary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X KY

Addresses

Primary practice location

125 Greenbriar Dr
Campbellsville, KY 42718-9616

Mailing address

1698 Old Lebanon Rd
Campbellsville, KY 42718-9662
Phone (270) 789-6087

Other practice location 1

236 Greenbriar Dr
Campbellsville, KY 42718-9624
Phone (207) 789-6166

Other identifiers 2

IdentifierTypeStateIssuer
7100013050MedicaidKY
7100477040MedicaidKY

Other names 2

  • TAYLOR REGIONAL ONCOLOGY Doing business as
  • TAYLOR REGIONAL ONCOLOGY-RADIATION Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051221000527 KY Part B Supplier - Clinic/Group Practice 4880616622 Receives reassigned benefits from 89 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, KY; Campbellsville, KY; Lebanon, KY; Greensburg, KY; Caompbellsville, KY

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Taylor Regional Medical Group15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1205017464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189662",
            "telephone_number": "270-789-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 GREENBRIAR DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189616",
            "telephone_number": "270-789-6166",
            "fax_number": "270-789-6198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "236 Greenbriar Dr",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "427189624",
            "country_code": "US",
            "telephone_number": "207-789-6166",
            "fax_number": "270-789-6198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAYLOR REGIONAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "270-465-3561"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100013050",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100477040",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAYLOR REGIONAL ONCOLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAYLOR REGIONAL ONCOLOGY-RADIATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.