Individual provider Active NPI

Myrtic Davis-Taylor

  • Registered Nurse
  • Floral Park, NY
National Provider Identifier
1245927797
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
580956 Issued in NY
Practice address
9519 240TH St
Floral Park, NY 11001-3830
Phone
(516) 315-0591
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 580956 NY Primary

Addresses

Primary practice location

9519 240TH St
Floral Park, NY 11001-3830

Mailing address

9519 240TH St
Floral Park, NY 11001-3830
Phone (516) 315-0591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
580956NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1245927797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9519 240TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013830",
            "telephone_number": "516-315-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9519 240TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013830",
            "telephone_number": "516-315-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-TAYLOR",
        "first_name": "MYRTIC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "580956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.