Individual provider Active NPI

Cheryl Ellen Taylor, MA EDS

  • Clinical Psychologist
  • Bluefield, WV
National Provider Identifier
1275860462
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
997 Issued in WV
Practice address
1333 Southview Drive
Bluefield, WV 24701-4317
Phone
(304) 325-4673
Fax
(304) 327-9210
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 0 WV
Clinical Psychologist 103TC0700X 997 WV Primary
Clinical Child & Adolescent Psychologist 103TC2200X 997
Cognitive & Behavioral Psychologist 103TB0200X 997
Counseling Psychologist 103TC1900X 997 WV
Family Psychologist 103TF0000X 997
Forensic Psychologist 103TF0200X 997
Marriage & Family Therapist 106H00000X 997
Forensic Psychologist 103TF0200X 997 WV
Group Psychotherapy Psychologist 103TP2701X 997 WV
Intellectual & Developmental Disabilities Psychologist 103TM1800X 997 WV
Psychologist 103T00000X 997 WV

Addresses

Primary practice location

1333 Southview Drive
Bluefield, WV 24701-4317

Mailing address

118 12TH Street
Princeton, WV 24740-2352
Phone (304) 487-7936

Other identifiers 1

IdentifierTypeStateIssuer
3810016308MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000341 WV Practitioner - Clinical Psychologist 1658513445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians

Practice addresses (Care Compare)

1333 Southview Dr
Bluefield, WV 24701-4317
Phone (304) 327-9205

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
997WVMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn., Inc CurrentSince Oct 7, 2023 Accepting new patients
Princeton Community Hospital Assn Inc. Current Accepting new patients
Princeton Community Hospital Assn., Inc. CurrentSince Oct 7, 2023 Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

1333 Southview Dr
Bluefield, WV 24701
Phone (304) 327-2900

Interoperability endpoints

  • Direct secure messaging: ctaylor358232@direct.wvuhsdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275860462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 12TH STREET",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402352",
            "telephone_number": "304-487-7936",
            "fax_number": "304-487-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 SOUTHVIEW DRIVE",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247014317",
            "telephone_number": "304-325-4673",
            "fax_number": "304-327-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CHERYL",
        "middle_name": "ELLEN",
        "credential": "MA EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WV",
            "license": "0",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "997",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": "997",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": "997",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": "997",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": "997",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": "997",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "997",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WV",
            "license": "997",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WV",
            "license": "997",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "WV",
            "license": "997",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016308",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, WV

Sources for this page

Verify at the official NPI Registry.