NPIMap

Individual provider Active NPI

Kent Alan Taub, MD

  • Emergency Medicine Physician
  • Southlake, TX
National Provider Identifier
1417061607
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J6042 Issued in TX
Practice address
613 Fairway View Ter
Southlake, TX 76092-9550
Phone
(214) 649-1444
NPI assigned
Aug 18, 2006
Last updated
Feb 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X J6042 TX Primary

Addresses

Primary practice location

613 Fairway View Ter
Southlake, TX 76092-9550

Mailing address

613 Fairway View Ter
Southlake, TX 76092-9550
Phone (214) 649-1444

Other identifiers 3

IdentifierTypeStateIssuer
P00759870OtherTXRAILROAD MEDICARE THRU HEB
8AB544OtherTXBCBSTX
138767225MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20101129000381 AL Practitioner - Emergency Medicine 4284613217 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians GroupGroup PAC ID 5496669350, 47 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-9889

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J6042TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Alabama LLC Emergency Medicine CurrentSince Mar 1, 2012 Accepting new patients
Decatur Morgan Emergency Medicine Emergency Medicine CurrentSince Mar 11, 2020 Accepting new patients
Immh Scottsboro LLC Emergency Medicine CurrentSince Oct 1, 2014 Accepting new patients
Emergency Physicians Group Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Emergency Health Services Associates, P.a. Emergency Medicine Past Accepting new patients
Heb Emergicare PA Emergency Medicine Past Accepting new patients
Hebron Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
PRMC ER Group Inc Past Accepting new patients
Dallas Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Texas Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Grapevine Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

1201 7th St SE
Decatur, AL 35601
Phone (256) 341-2000

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

380 Woods Cove Rd
Scottsboro, AL 35768
Phone (256) 218-3579

Organizations & group practices 11

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1417061607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 FAIRWAY VIEW TER",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929550",
            "telephone_number": "214-649-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 FAIRWAY VIEW TER",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929550",
            "telephone_number": "214-649-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUB",
        "first_name": "KENT",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J6042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE THRU HEB",
            "identifier": "P00759870",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8AB544",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138767225",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.