Individual provider Active NPI

Wade Randolph Taylor, DO

  • Family Medicine Physician
  • Owensboro, KY
National Provider Identifier
1215425038
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04993 Issued in KY
Practice address
2211 Mayfair Dr Ste 101
Owensboro, KY 42301-4569
Phone
(270) 688-1352
Fax
(270) 683-4313
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Family Medicine Physician 207Q00000X 04993 KY Primary

Addresses

Primary practice location

2211 Mayfair Dr Ste 101
Owensboro, KY 42301-4569

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 592-2756

Other practice location 2

1200 Barret Blvd
Henderson, KY 42420-4950
Phone (270) 844-8600

Other practice location 3

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

Other practice location 4

2211 Mayfair Dr Ste 102
Owensboro, KY 42301-4569
Phone (270) 688-1351

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address wtaylor111392@direct.owensborohealth.org Direct
Direct Messaging Address wtaylor111392@direct.owensborohealth.org Direct
Direct Messaging Address wtaylor111392@direct.owensborohealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210901003500 KY Practitioner - Family Practice 8022414895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients
Owensboro Health Medical Group, Inc Family Medicine Past Accepting new patients

Locations

1200 Barret Blvd
Henderson, KY 42420
Phone (270) 844-8600

510 Ruby Dr
Madisonville, KY 42431
Phone (270) 399-7757

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

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.

Hospital & facility affiliations 1

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1215425038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 101",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014569",
            "telephone_number": "270-688-1352",
            "fax_number": "270-683-4313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11375 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135409",
            "country_code": "US",
            "telephone_number": "352-592-2756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Barret Blvd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424204950",
            "country_code": "US",
            "telephone_number": "270-844-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Ruby Dr",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424312168",
            "country_code": "US",
            "telephone_number": "270-399-7900",
            "fax_number": "270-399-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 Mayfair Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423014569",
            "country_code": "US",
            "telephone_number": "270-688-1351",
            "fax_number": "270-683-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "WADE",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtaylor111392@direct.owensborohealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2211 Mayfair Dr Ste 101",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423014569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtaylor111392@direct.owensborohealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "510 Ruby Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtaylor111392@direct.owensborohealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 Barret Blvd",
            "city": "Henderson",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424204950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.