Individual provider Active NPI

Timothy Cowdery Taylor, L.C.S.W.

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1447204268
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000796 Issued in VA
Practice address
2580 Potters Rd
Virginia Beach, VA 23454-4324
Phone
(757) 498-9391
Fax
(757) 498-7073
NPI assigned
May 19, 2006
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904000796 VA Primary

Addresses

Primary practice location

2580 Potters Rd
Virginia Beach, VA 23454-4324

Mailing address

2580 Potters Rd
Virginia Beach, VA 23454-4324
Phone (757) 498-9391

Other identifiers 1

IdentifierTypeStateIssuer
008912971MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111119000073 VA Practitioner - Clinical Social Worker 3870767304 Practice locations: Norfolk, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

919 W 21St St
Suite B
Norfolk, VA 23517-1559
Phone (757) 622-6794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904000796VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1447204268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 POTTERS RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544324",
            "telephone_number": "757-498-9391",
            "fax_number": "757-498-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 POTTERS RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544324",
            "telephone_number": "757-498-9391",
            "fax_number": "757-498-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TIMOTHY",
        "middle_name": "COWDERY",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008912971",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.