Andre Taylor, ATC

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

2016027857 Issued in MO

Practice address

601 E 14TH St
Sedalia, MO 65301-5972

Phone

(660) 287-1225

NPI assigned

May 5, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1477089753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 PEBBLECREEK DR",
            "address_2": "APT. B",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640939502",
            "telephone_number": "573-433-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972",
            "telephone_number": "660-287-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ANDRE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "MO",
            "license": "2016027857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunny Meadows Living Center
• Surgical Services of Sedalia LLC
• Stephanie L Sutherland, PMHNP
• Sylvia G. Thompson Residence Center
• Sylvia G. Thompson Residence Center, Inc.
• Capri Angelic Taylor, MA,LPC, LMHC, SAP
• Cynthia Ann Taylor, LCSW
• Samuel M Temesgen, M.D.
• Anne Tempel, PA-C
• Jeffrey D Terrell, CRNA

• All providers in Sedalia, MO
• Sports Medicine (Preventive Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.