Michelle Elizabeth Taylor, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2605 Issued in MN

Practice address

4243 4TH Ave S
Minneapolis, MN 55409-2113

Phone

(612) 821-2003

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A Chance to Grow, Inc.

  • Optometrist
  • Minneapolis, MN
  • NPI 1720347875
  Medicare reassignment
• Southside Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1538137757
  NPD
• Southside Community Health Services, Inc.

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1679690952
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1528090420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 4TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554092113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 4TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554092113",
            "telephone_number": "612-821-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "A Chance to Grow Vision",
            "address_2": "1800 2nd St NE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554184306",
            "country_code": "US",
            "telephone_number": "612-706-5540",
            "fax_number": "612-706-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MN",
            "license": "2605",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "592325500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Taylor
• Lalondra Rose Taylor
• Leann Taylor, MA CF SLP
• Mark Allen Taylor, IDC
• Michael K Taylor, M.D.
• Rachel Elizabeth Taylor, RN
• Ronald L Taylor
• Rosanna Taylor
• Sarah Elizabeth Taylor, PSYD
• Todd Lee Taylor

• Optometrist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.