NPIMap

Organization Active NPI

Taylor Rehab Inc

  • Physical Therapist
  • Mooresville, NC
National Provider Identifier
1215977160
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5450 Issued in NC
Legal business name
TAYLOR REHAB INC
Practice address
114 Welton Way
Suite B
Mooresville, NC 28117-9163
Phone
(704) 660-6551
Fax
(704) 660-9894
NPI assigned
Jun 8, 2006
Last updated
Aug 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Mr. Shawn K Taylor, PTNPI 1194739698
Title
President Owner
Phone
(704) 660-6551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5450 NC Primary

Addresses

Primary practice location

114 Welton Way
Suite B
Mooresville, NC 28117-9163

Mailing address

114 Welton Way
Suite B
Mooresville, NC 28117-9163
Phone (704) 660-6551

Other identifiers 1

IdentifierTypeStateIssuer
7210646MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080820000288 NC Part B Supplier - Clinic/Group Practice 4587558846 Receives reassigned benefits from 14 practitioners
Practice locations: Mooresville, NC

National Provider Directory

National Provider Directory

Locations

114 Welton Way
Ste B
Mooresville, NC 28117
Phone (704) 660-6551

167 Gateway Blvd
Mooresville, NC 28117
Phone (704) 658-1095

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1215977160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WELTON WAY",
            "address_2": "SUITE B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179163",
            "telephone_number": "704-660-6551",
            "fax_number": "704-660-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WELTON WAY",
            "address_2": "SUITE B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179163",
            "telephone_number": "704-660-6551",
            "fax_number": "704-660-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "704-660-6551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "5450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210646",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.