Individual provider Active NPI

Jalyn Latisha Taylor

  • Physician Assistant
  • Mobile, AL
National Provider Identifier
1205674413
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13559 Issued in GA
Practice address
5721 USA Drive North
Mobile, AL 36688-0001
Phone
(251) 445-9334
NPI assigned
Jul 20, 2024
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 13559 GA Primary

Addresses

Primary practice location

5721 USA Drive North
Mobile, AL 36688-0001

Mailing address

2730 Ashbury LN
Cantonment, FL 32533-6626
Phone (850) 529-9962

Other practice location 1

4645 Timber Ridge Dr
Douglasville, GA 30135-7541
Phone (770) 942-7696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260225002329 GA Practitioner - Physician Assistant 6608357835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Northridge Rd
Suite 400
Atlanta, GA 30350-3314

P O Box
Suite 23662
New York, NY 10087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13559GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Allergy & Asthma Clinic PA CurrentSince Dec 10, 2025 Accepting new patients

Locations

100 Old Ball Ground Hwy
#B
Canton, GA 30114
Phone (770) 720-8000

4645 Timber Ridge Dr
Ste 160
Douglasville, GA 30135
Phone (770) 942-7696

114 Townpark Dr NW
Ste 240
Kennesaw, GA 30144
Phone (770) 485-3723

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1205674413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 ASHBURY LN",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325336626",
            "telephone_number": "850-529-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 USA DRIVE NORTH",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366880001",
            "telephone_number": "251-445-9334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4645 Timber Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301357541",
            "country_code": "US",
            "telephone_number": "770-942-7696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JALYN",
        "middle_name": "LATISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.