Individual provider Active NPI

Taylor Ryan McLain, MD

  • Pediatrics Physician
  • Puyallup, WA
National Provider Identifier
1407242530
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60946290 Issued in WA
Practice address
11102 Sunrise Blvd E Ste 103
Puyallup, WA 98374
Phone
(253) 848-8797
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60946290 WA Primary

Addresses

Primary practice location

11102 Sunrise Blvd E Ste 103
Puyallup, WA 98374

Mailing address

11102 Sunrise Blvd E Ste 103
Puyallup, WA 98374-8846
Phone (253) 848-8797

Other practice location 1

1 Baylor Plz # Bcm320
Houston, TX 77030
Phone (832) 824-1170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191101002052 WA Practitioner - Pediatric Medicine 9638425861 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60946290WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 1, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Aug 1, 2022 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

11102 Sunrise Blvd E
Ste 103
Puyallup, WA 98374
Phone (253) 848-8797

316 S K St
Ste 212
Tacoma, WA 98405
Phone (253) 383-5777

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1407242530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E STE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748846",
            "telephone_number": "253-848-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E STE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Baylor Plz # Bcm320",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "832-824-1170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLAIN",
        "first_name": "TAYLOR",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60946290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.