Active NPI
Taylor Ballard, D.O.
- Pediatric Surgery Physician
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 96878
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | 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
- 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.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
- Prosthetic/Orthotic Supplier
- Jackson, MS
- NPI 1235019530
-
- Rehabilitation Clinic/Center
- Jackson, MS
- NPI 1619778586
-
- Internal Medicine Physician
- Jackson, MS
- NPI 1609984574
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.