Individual provider Active NPI

Taylor Gray Hallman, MD

  • Plastic Surgery Physician
  • Springfield, IL
National Provider Identifier
1265296354
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
125.086159 Issued in IL
Practice address
301 N 8TH St Ste 3A158
Springfield, IL 62701-1085
Phone
(217) 545-3134
NPI assigned
Feb 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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
Plastic Surgery Physician 208200000X 125.086159 IL Primary

Addresses

Primary practice location

301 N 8TH St Ste 3A158
Springfield, IL 62701-1085

Mailing address

301 N 8TH St Ste 3A158
Springfield, IL 62701-1085
Phone (217) 545-3134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250722003267 IL Order and Referring Only - Plastic and Reconstructive SurgeryPractitioner - Plastic and Reconstructive Surgery 3173039534

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.086159ILMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1265296354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST STE 3A158",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011085",
            "telephone_number": "217-545-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST STE 3A158",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011085",
            "telephone_number": "217-545-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLMAN",
        "first_name": "TAYLOR",
        "middle_name": "GRAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "125.086159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.