Active NPI
Taylor Heath
- Physician Assistant
- Wake Forest, NC
National Provider Identifier
1255816450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-08505
- Practice address
- 620 Dr Calvin Jones Hwy # 212
Wake Forest, NC 27587-3100 - Phone
- (919) 761-5678
- NPI assigned
- Oct 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-08505 | NC | Primary |
Addresses
Primary practice location
620 Dr Calvin Jones Hwy # 212
Wake Forest, NC 27587-3100
Mailing address
8203 Penuche Way
Holly Springs, NC 27540-3378
Phone (320) 282-4402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181228000772 | NC | Practitioner - Physician Assistant | 6406191105 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-08505 | NC | MD | Physician Assistant |
Interoperability endpoints
- taylorheath@huc.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1255816450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8203 PENUCHE WAY",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275403378",
"telephone_number": "320-282-4402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 DR CALVIN JONES HWY # 212",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275873100",
"telephone_number": "919-761-5678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-03",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.