Active NPI
Nicole Mary Taylor, PHD
- Psychologist
- Indianapolis, IN
National Provider Identifier
1477613263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20041755A
- Practice address
- 7212 Mogul Way
Indianapolis, IN 46259-7765 - Phone
- (317) 502-3459
- Fax
- (317) 788-2120
- NPI assigned
- Dec 11, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20041755A | IN | Primary |
Addresses
Primary practice location
7212 Mogul Way
Indianapolis, IN 46259-7765
Mailing address
7212 Mogul Way
Indianapolis, IN 46259-7765
Phone (317) 502-3459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Addiction Services Inc. | Psychologist | Current | Accepting new patients |
Locations
1431 N Delaware St
Indianapolis, IN 46202
Phone (317) 536-7100
6350 N Shadeland Ave
Ste 5
Indianapolis, IN 46220
Phone (317) 887-3290
1440 Hudson St
Indianapolis, IN 46202
Phone (317) 887-3290
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Indianapolis, IN
- NPI 1043439169
Psychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1477613263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7212 MOGUL WAY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462597765",
"telephone_number": "317-502-3459",
"fax_number": "317-788-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7212 MOGUL WAY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462597765",
"telephone_number": "317-502-3459",
"fax_number": "317-788-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "NICOLE",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20041755A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.