Individual provider Active NPI

La Tonya Renee Taylor, CNA1

  • Nurse's Aide
  • Kernersville, NC
National Provider Identifier
1588866560
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
55183 Issued in NC
Practice address
125 Pegg Ave
Kernersville, NC 27284-2433
Phone
(336) 995-7816
Fax
(336) 996-2594
NPI assigned
Jun 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 55183 NC Primary

Addresses

Primary practice location

125 Pegg Ave
Kernersville, NC 27284-2433

Mailing address

125 Pegg Ave
Kernersville, NC 27284-2433
Phone (336) 995-7816

Other names 1

  • Ms. La Tonya Renee Taylor Former name

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

State licenses

LicenseStateTypeSpecialty
55183NCMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588866560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PEGG AVE",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842433",
            "telephone_number": "336-995-7816",
            "fax_number": "336-996-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PEGG AVE",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842433",
            "telephone_number": "336-995-7816",
            "fax_number": "336-996-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LA TONYA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "CNA1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "55183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LA TONYA",
            "last_name": "TAYLOR",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "CNA2",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.