NPIMap

Individual provider Active NPI

David Provosty Taylor Jr., M.D.

  • Obstetrics & Gynecology Physician
  • Gulfport, MS
National Provider Identifier
1508186990
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
23293 Issued in MS
Practice address
4502 Old Pass Rd
Gulfport, MS 39501
Phone
(228) 863-9977
Fax
(228) 863-9912
NPI assigned
Jun 8, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 23293 MS Primary

Addresses

Primary practice location

4502 Old Pass Rd
Gulfport, MS 39501

Mailing address

4502 Old Pass Rd
Gulfport, MS 39501
Phone (228) 863-9977

Other identifiers 2

IdentifierTypeStateIssuer
R10473MedicaidAL
03604211MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002001868 MS Practitioner - Obstetrics/Gynecology 0547409294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4577 13TH St
Gulfport, MS 39501-2516
Phone (228) 864-2752

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Jan 19, 2021 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Dec 31, 2023 Accepting new patients
Gulfport Obstetrical & Gynecological Clinic, PA Current Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Jan 19, 2021 Accepting new patients
Gulfport OBGYN Clinic, LLC CurrentSince Jan 1, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Dec 31, 2023 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

15190 Community Rd
Ste 310
Gulfport, MS 39503
Phone (228) 539-7044

4502 Old Pass Rd
Gulfport, MS 39501
Phone (228) 314-7226

4577 13th St
Gulfport, MS 39501
Phone (228) 864-2752

Interoperability endpoints

  • Direct secure messaging: dtaylor@direct.mhg.com

Organizations & group practices 10

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.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508186990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DAVID",
        "middle_name": "PROVOSTY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "23293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R10473",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03604211",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.