Individual provider Active NPI

Anna Marie Taylor, MED, LAT, ATC

  • Athletic Trainer
  • Walla Walla, WA
National Provider Identifier
1588027916
Registry record updated Apr 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A160196640 Issued in WA
Practice address
500 Tausick Way
Walla Walla, WA 99362-9270
Phone
(509) 527-1860
Fax
(509) 527-4321
NPI assigned
Apr 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A160196640 WA Primary

Addresses

Primary practice location

500 Tausick Way
Walla Walla, WA 99362-9270

Mailing address

500 Tausick Way
Walla Walla, WA 99362-9270
Phone (509) 527-1860

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)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
A160196640WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459555200000",
    "number": "1588027916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TAUSICK WAY",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993629270",
            "telephone_number": "509-527-1860",
            "fax_number": "509-527-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TAUSICK WAY",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993629270",
            "telephone_number": "509-527-1860",
            "fax_number": "509-527-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "MED, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-02",
        "last_updated": "2016-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160196640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.