Individual provider Active NPI

Taylor Ballard, D.O.

  • Pediatric Surgery Physician
  • Greenville, SC
National Provider Identifier
1487185252
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
96878 Issued in SC
Practice address
48 Cross Park CT
Greenville, SC 29605-4263
Phone
(864) 522-8603
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 96878 SC Primary
Pediatric Surgery Physician 2086S0120X 28480 MS

Addresses

Primary practice location

48 Cross Park CT
Greenville, SC 29605-4263

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8603

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-1292

Other names 1

  • Taylor Shaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716000588 MS Practitioner - General Surgery 6507120177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Apr 29, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Apr 29, 2025 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1516 23rd Ave
Meridian, MS 39301
Phone (601) 553-6491

Interoperability endpoints

  • Direct secure messaging: tshaw78086@ummc.direct-ci.com

Organizations & group practices 4

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1487185252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CROSS PARK CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054263",
            "telephone_number": "864-522-8603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-815-1292",
            "fax_number": "601-984-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "TAYLOR",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "SC",
            "license": "96878",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MS",
            "license": "28480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "SHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.