Active NPI
Stanley Douglas Taylor, MD
- Pediatrics Physician
- Jacksonville, NC
National Provider Identifier
1295893857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23340
- Practice address
- 1201 Country Club Rd
Jacksonville, NC 28546-6807 - Phone
- (910) 347-7773
- Fax
- (910) 347-7792
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23340 | NC | Primary |
Addresses
Primary practice location
1201 Country Club Rd
Jacksonville, NC 28546-6807
Mailing address
504 Sanal Court
Jacksonville, NC 28540
Phone (910) 347-7773
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89131NN | Medicaid | NC | |
| 562095466001 | Other | TRICARE HUMANA | |
| B6631 | Other | MEDCOST | |
| 131NN | Other | BCBS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23340 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onslow Health Associates PLLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Jacksonville, NC
- NPI 1437236338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1295893857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 SANAL COURT",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28540",
"telephone_number": "910-347-7773",
"fax_number": "910-347-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 COUNTRY CLUB RD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466807",
"telephone_number": "910-347-7773",
"fax_number": "910-347-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "STANLEY",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "23340",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89131NN",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE HUMANA",
"identifier": "562095466001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "B6631",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "131NN",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.