Individual provider Active NPI

Michael Lee Taylor, DC

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1356539365
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC19631 Issued in CA
Practice address
1421 Standiford Ave Ste B
Modesto, CA 95350-0730
Phone
(209) 521-1222
Fax
(209) 521-4075
NPI assigned
Oct 4, 2007
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC19631 CA Primary

Addresses

Primary practice location

1421 Standiford Ave Ste B
Modesto, CA 95350-0730

Mailing address

1421 Standiford Ave Ste B
Modesto, CA 95350-0730
Phone (209) 521-1122

Other identifiers 1

IdentifierTypeStateIssuer
7345231MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081118000681 CA Practitioner - Chiropractic 1951461185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1421 Standiford Ave
Suite B
Modesto, CA 95350-0730
Phone (209) 521-1122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19631CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Michael Lee Taylor a Prof Chiro Chiropractor CurrentSince May 1, 2008 Accepting new patients

Locations

1421 Standiford Ave
Ste B
Modesto, CA 95350
Phone (209) 521-1122

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.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1356539365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 STANDIFORD AVE STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500730",
            "telephone_number": "209-521-1122",
            "fax_number": "209-521-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 STANDIFORD AVE STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500730",
            "telephone_number": "209-521-1222",
            "fax_number": "209-521-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC19631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7345231",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.