Individual provider Active NPI

Jane Taylor, MD

  • Pediatrics Physician
  • Roscoe, IL
National Provider Identifier
1588827588
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036127542 Issued in IL
Practice address
5000 Prairie Rose Dr
Roscoe, IL 61073-7792
Phone
(815) 971-2000
Fax
(815) 971-9070
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036127542 IL Primary

Addresses

Primary practice location

5000 Prairie Rose Dr
Roscoe, IL 61073-7792

Mailing address

2400 N Rockton Ave
Att. RMH-Med Staff Credentialing
Rockford, IL 61103-3655
Phone (815) 971-2000

Other names 1

  • Jane Kim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110606000382 IL Practitioner - Pediatric Medicine 6709063464 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127542ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Pathologists, LTD Current Accepting new patients
Rockford Health Physicians CurrentSince Jul 17, 2014 Accepting new patients

Locations

Carol Stream, IL 60122

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Interoperability endpoints

  • Direct secure messaging: jtaylor48665@direct.mhemail.org

Organizations & group practices 2

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1588827588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE",
            "address_2": "ATT. RMH-MED STAFF CREDENTIALING",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033655",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 PRAIRIE ROSE DR",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737792",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036127542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "KIM",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roscoe, IL

Sources for this page

Verify at the official NPI Registry.