Individual provider Active NPI

Richard R Taylor, M.D.

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1588736607
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1365 Issued in AK
Practice address
2211 E Northern Lights Blvd
Anchorage, AK 99508-4103
Phone
(907) 279-8486
Fax
(907) 257-8180
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1365 AK Primary

Addresses

Primary practice location

2211 E Northern Lights Blvd
Anchorage, AK 99508-4103

Mailing address

2211 E Northern Lights Blvd
Anchorage, AK 99508-4103
Phone (907) 279-8486

Other identifiers 1

IdentifierTypeStateIssuer
MD1365MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111012000293 AK Practitioner - Family PracticePractitioner - Internal Medicine 6901078187 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1365AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Alaska Department of Administration CurrentSince Aug 28, 2015 Accepting new patients

Locations

3700 Piper St
Anchorage, AK 99508
Phone (907) 269-7100

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1588736607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 E NORTHERN LIGHTS BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084103",
            "telephone_number": "907-279-8486",
            "fax_number": "907-257-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E NORTHERN LIGHTS BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084103",
            "telephone_number": "907-279-8486",
            "fax_number": "907-257-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "RICHARD",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1365",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.