Active NPI
Macy B Russell Taylor, PHARMD
- Pharmacist
- Marion, IL
National Provider Identifier
1477195949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.302668
- Practice address
- 2802 Outer Dr
Marion, IL 62959-5207 - Phone
- (618) 997-2021
- NPI assigned
- Oct 16, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.302668 | IL | Primary |
Addresses
Primary practice location
2802 Outer Dr
Marion, IL 62959-5207
Mailing address
13630 Bandyville Rd
Herrin, IL 62948-6514
Phone (618) 694-5318
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.302668 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1477195949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13630 BANDYVILLE RD",
"city": "HERRIN",
"state": "IL",
"postal_code": "629486514",
"telephone_number": "618-694-5318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 OUTER DR",
"city": "MARION",
"state": "IL",
"postal_code": "629595207",
"telephone_number": "618-997-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL TAYLOR",
"first_name": "MACY",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.302668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.