Active NPI
Maxwell Floyd Taylor III, PSY.D., DLLP
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1275978314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016920
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 281-6372
- Fax
- (616) 281-6459
- NPI assigned
- May 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016920 | MI | Primary |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
170 Leonard NE
Grand Rapids, MI 49505
Phone (616) 956-1122
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016920 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1275978314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 LEONARD NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49505",
"telephone_number": "616-956-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-281-6372",
"fax_number": "616-281-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "MAXWELL",
"middle_name": "FLOYD",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PSY.D., DLLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-02",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.