Active NPI
Waller L Taylor Jr., MD
- Ophthalmology Physician
- Virginia Beach, VA
National Provider Identifier
1437260809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0101018250
- Practice address
- 1821 Old Donation Parkway
Suite 1
Virginia Beach, VA 23454-3033 - Phone
- (757) 481-6954
- Fax
- (757) 481-1965
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0101018250 | VA | Primary |
Addresses
Primary practice location
1821 Old Donation Parkway
Suite 1
Virginia Beach, VA 23454-3033
Mailing address
1821 Old Donation Parkway
Suite 1
Virginia Beach, VA 23454-3033
Phone (757) 481-6954
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890616R | Medicaid | NC | |
| 918190 | Other | EYE MED | |
| 1099195 | Other | FIRST HEALTH | |
| 77473 | Other | SENTARA | |
| 065727 | Other | ANTHEM | |
| 6212000 | Other | DAVIS VISION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437260809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 OLD DONATION PARKWAY",
"address_2": "SUITE 1",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234543033",
"telephone_number": "757-481-6954",
"fax_number": "757-481-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 OLD DONATION PARKWAY",
"address_2": "SUITE 1",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234543033",
"telephone_number": "757-481-6954",
"fax_number": "757-481-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "WALLER",
"middle_name": "L",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0101018250",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890616R",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED",
"identifier": "918190",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1099195",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "77473",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "065727",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "6212000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.