Individual provider Active NPI

Nicole Mary Taylor, PHD

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1477613263
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20041755A Issued in IN
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

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201013000958 IN Practitioner - Clinical Psychologist 1850711839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Community Addiction Services Inc. Psychologist CurrentSince Feb 16, 2021 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.

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

Verify at the official NPI Registry.