Active NPI
Mark W Taylor, MD
- Ophthalmology Physician
- Gig Harbor, WA
National Provider Identifier
1558393595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 33887
- Practice address
- 4700 Point Fosdick Drive NW
Ste 112
Gig Harbor, WA 98335 - Phone
- (253) 759-5555
- Fax
- (253) 830-5420
- NPI assigned
- Jul 7, 2006
- Last updated
- Mar 5, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 33887 | WA | Primary |
Addresses
Primary practice location
4700 Point Fosdick Drive NW
Ste 112
Gig Harbor, WA 98335
Mailing address
3602 S 19TH Street
Tacoma, WA 98405
Phone (253) 759-5555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8194854 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33887 | WA | MD | Ophthalmology Physician |
Interoperability endpoints
- mark.taylor@832.chartlogic.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1558393595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 S 19TH STREET",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-759-5555",
"fax_number": "253-830-5420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 POINT FOSDICK DRIVE NW",
"address_2": "STE 112",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "98335",
"telephone_number": "253-759-5555",
"fax_number": "253-830-5420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "MARK",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WA",
"license": "33887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8194854",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gig Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.