Individual provider Active NPI

Grant D Taylor, MD

  • Urology Physician
  • Kingsport, TN
National Provider Identifier
1427013044
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD39734 Issued in TN
Practice address
2204 Pavilion Dr Ste 310
Kingsport, TN 37660-4653
Phone
(423) 246-4155
NPI assigned
Apr 18, 2006
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD39734 TN Primary

Addresses

Primary practice location

2204 Pavilion Dr Ste 310
Kingsport, TN 37660-4653

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other identifiers 1

IdentifierTypeStateIssuer
3329892MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050627001243 TN Practitioner - Urology 7618912999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical School at Houston, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200

2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 578-8500

2204 Pavilion Dr
Suite 110
Kingsport, TN 37660-4651
Phone (423) 224-2369

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD39734TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Dec 31, 2023 Accepting new patients
Johnson City Urological Clinic, P.C. CurrentSince May 14, 2009 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Dec 31, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2340 Knob Creek Rd
Ste 720
Johnson City, TN 37604
Phone (423) 926-6112

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

2204 Pavilion Dr
Ste 310
Kingsport, TN 37660
Phone (423) 224-3900

Interoperability endpoints

  • Direct secure messaging: granttaylor@jcuc.medalliesdirect.net

Organizations & group practices 4

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 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1427013044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR STE 310",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604653",
            "telephone_number": "423-246-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GRANT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD39734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3329892",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.