John Richard Taylor III, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2010041285 Issued in MO

Practice address

2813 Forest Ave
Granite City, IL 62040-6025

Phone

(618) 670-8584

NPI assigned

Jun 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1386905396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 FOREST AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406025",
            "telephone_number": "618-670-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 FOREST AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406025",
            "telephone_number": "618-670-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2010041285",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160005050",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julienne Carol Szlufik, APN
• Talley Chiropractic, PC
• Jason R Talley, DC
• Stephanie Tanwangco, FNP
• Jessica Marie Taul, PT, DPT
• Taylorville Chiropractic Clinic LTD.
• Noah Matthew Tennyson, PHARM.D.
• The Hope Clinic for Women, LTD
• The Hope Clinic for Women, LTD
• Leyland Arthur Thomas, MD

• Physical Therapy Assistant in Granite City, IL
• Providers in Granite City, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.