NPIMap

Individual provider Active NPI

Alan Nicholas Taylor, PA-C

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1558706309
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6804 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd NE Ste 825
Atlanta, GA 30342-1771
Phone
(404) 255-5595
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 6804 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd NE Ste 825
Atlanta, GA 30342-1771

Mailing address

925 Canterbury Rd NE Apt 1137
Atlanta, GA 30324-2896
Phone (706) 615-1913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160701000511 GA Practitioner - Physician Assistant 7719279223 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6804GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Anesthesia Consultants, PC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1558706309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CANTERBURY RD NE APT 1137",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303242896",
            "telephone_number": "706-615-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE STE 825",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421771",
            "telephone_number": "404-255-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ALAN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "6804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.