Individual provider Active NPI

Taylor Ilayne Nelson, PA-C

  • Medical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1467952812
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1311 E Millbrook Rd
Raleigh, NC 27609-5473
Phone
(919) 719-0119
NPI assigned
Feb 12, 2018
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NC Primary

Addresses

Primary practice location

1311 E Millbrook Rd
Raleigh, NC 27609-5473

Mailing address

600 Saint Marys St Apt 331
Raleigh, NC 27605-1793
Phone (458) 239-7971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180312000431 PA Practitioner - Physician Assistant 2365703238 Reassigns benefits to 1 organization
I20200717001545 NC Practitioner - Physician Assistant 2365703238 Reassigns benefits to 1 organization
I20231006002962 MD Practitioner - Physician Assistant 2365703238

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX High Point PLLCGroup PAC ID 7113061730, 48 clinicians

Practice addresses (Care Compare)

1231 Eastchester Dr
High Point, NC 27265-3102
Phone (336) 884-4050

6400 Fayetteville Rd
Durham, NC 27713-6178
Phone (919) 551-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Mar 1, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Mar 1, 2018 Accepting new patients
DRX High Point, PLLC PastSince May 12, 2024 Accepting new patients

Locations

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

116 S Elmer Ave
Sayre, PA 18840
Phone (570) 887-2849

275 Guthrie Dr
Troy, PA 16947
Phone (570) 297-2121

Interoperability endpoints

  • Direct secure messaging: tnelson130776@direct-guthrie.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1467952812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SAINT MARYS ST APT 331",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051793",
            "telephone_number": "458-239-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E MILLBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095473",
            "telephone_number": "919-719-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TAYLOR",
        "middle_name": "ILAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.