Individual provider Active NPI

McKenna Anne Taylor

  • Physician Assistant
  • Valley City, ND
National Provider Identifier
1265239073
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC1168 Issued in ND
Practice address
520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone
(701) 845-6000
NPI assigned
Feb 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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
Physician Assistant 363A00000X PAC1168 ND Primary

Addresses

Primary practice location

520 Chautauqua Blvd
Valley City, ND 58072-3145

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1234 5th Ave NW
Valley City, ND 58072-2081
Phone (701) 490-2554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20250904003190 ND Practitioner - Physician Assistant 3072015585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

520 Chautauqua Blvd
Valley City, ND 58072
Phone (701) 845-6000

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 3

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 6

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": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1265239073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CHAUTAUQUA BLVD",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580723145",
            "telephone_number": "701-845-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 5th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Valley City",
            "state": "ND",
            "postal_code": "580722081",
            "country_code": "US",
            "telephone_number": "701-490-2554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MCKENNA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC1168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley City, ND

Sources for this page

Verify at the official NPI Registry.