Brent Robert Taylor, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

73661 Issued in GA

Practice address

1541 Riverside Ave
Jacksonville, FL 32204-4124

Phone

(866) 400-3376

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Micrographic Dermatologic Surgery (MDS)

Education

Vanderbilt University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology and Mohs Surgery of Atlanta LLCGroup PAC ID 0840579793, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Premier Dermatology and Mohs Surgery of Atlanta LLC

  • Dermatology Physician
  • Alpharetta, GA
  • NPI 1588118574

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• North Georgia Dermatology, P.C.

  • Dermatology Physician
  • Lawrenceville, GA
  • NPI 1154483139

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1316175128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 N POINT PKWY",
            "address_2": "STE 420",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054568",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044124",
            "telephone_number": "866-400-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRENT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "32031",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "73661",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A124812",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "73661",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME120226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012735800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Taylor, CNA
• Angela Taylor, CCC-SLP
• Anita Taylor
• Ann Marie Taylor
• Batelhem Taylor
• Bridgett Taylor
• Cayla Taylor, PA-C
• Charles Edward Taylor III
• Chelsea Rachelle Taylor
• Edward Calhoun Taylor, PHD

• MOHS-Micrographic Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.