Individual provider Active NPI

Taylor Drake Kenyon, MS, MPH

  • Student in an Organized Health Care Education/Training Program
  • Terre Haute, IN
National Provider Identifier
1447097837
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
620 N Chestnut Street Holmstedt Hall 135
Terre Haute, IN 47809-0001
Phone
(317) 371-0979
NPI assigned
Jul 11, 2024
Last updated
Dec 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

620 N Chestnut Street Holmstedt Hall 135
Terre Haute, IN 47809-0001

Mailing address

620 N Chestnut Street Holmstedt Hall 135
Terre Haute, IN 47809-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20260624003072 OH Order and Referring Only - General SurgeryPractitioner - General Surgery 3577036284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1447097837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N CHESTNUT STREET HOLMSTEDT HALL 135",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478090001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N CHESTNUT STREET HOLMSTEDT HALL 135",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478090001",
            "telephone_number": "317-371-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "TAYLOR",
        "middle_name": "DRAKE",
        "credential": "MS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.