NPIMap

Individual provider Active NPI

Tanika R Taylor, MD

  • Obstetrics & Gynecology Physician
  • Louisville, KY
National Provider Identifier
1396900445
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
41813 Issued in KY
Practice address
4010 Dupont Cir
Suite L-07
Louisville, KY 40207-4812
Phone
(502) 895-6559
Fax
(502) 895-8994
NPI assigned
Jul 28, 2008
Last updated
Dec 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 41813 KY Primary

Addresses

Primary practice location

4010 Dupont Cir
Suite L-07
Louisville, KY 40207-4812

Mailing address

4010 Dupont Cir
Suite L-07
Louisville, KY 40207-4812
Phone (502) 895-6559

Other identifiers 2

IdentifierTypeStateIssuer
000000574746OtherKYANTHEM BCBS
7100050820MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000509 KY Practitioner - Obstetrics/Gynecology 0547336182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Louisville School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Women OB/GYN, PSCGroup PAC ID 2769455781, 5 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite L07
Louisville, KY 40207-4812
Phone 5028956559205

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41813KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Women OB/GYN, PSC Obstetrics & Gynecology CurrentSince Aug 1, 2014 Accepting new patients

Locations

4010 DuPont Cir
Ste L07
Louisville, KY 40207
Phone (502) 895-6559

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1396900445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE L-07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE L-07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TANIKA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "41813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000574746",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100050820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.