Active NPI
Taylor Rae McIllwain
- Social Worker
- Hillsboro, MO
National Provider Identifier
1497476501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2022017408
- Practice address
- 305 3Rd St
Hillsboro, MO 63050-4357 - Phone
- (636) 543-4510
- NPI assigned
- Sep 7, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2022017408 | MO | Primary |
Addresses
Primary practice location
305 3Rd St
Hillsboro, MO 63050-4357
Mailing address
10079 Dugout Rd
Cadet, MO 63630-9691
Phone (636) 543-4510
Other practice location 1
10079 Dugout Rd
Cadet, MO 63630-9691
Phone (636) 543-4510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022017408 | MO | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson Franklin Community Action Corp | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Hillsboro, MO
- NPI 1942747118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1497476501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10079 DUGOUT RD",
"city": "CADET",
"state": "MO",
"postal_code": "636309691",
"telephone_number": "636-543-4510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 3RD ST",
"city": "HILLSBORO",
"state": "MO",
"postal_code": "630504357",
"telephone_number": "636-543-4510"
}
],
"practiceLocations": [
{
"address_1": "10079 Dugout Rd",
"address_purpose": "LOCATION",
"city": "Cadet",
"state": "MO",
"postal_code": "636309691",
"country_code": "US",
"telephone_number": "636-543-4510",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCILLWAIN",
"first_name": "TAYLOR",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-07",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2022017408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.