NPIMap

Organization Active NPI

Taylor Regjional Medical Group,LLC

  • Ophthalmology Physician
  • Campbellsville, KY
National Provider Identifier
1619316239
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TAYLOR REGJIONAL MEDICAL GROUP,LLC
Practice address
125 Kingswood Dr
Campbellsville, KY 42718-9634
Phone
(270) 789-6087
Fax
(270) 789-6119
NPI assigned
Jun 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Melissa Carter
Title
Office Coordinator
Phone
(270) 789-6087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

125 Kingswood Dr
Campbellsville, KY 42718-9634

Mailing address

1698 Old Lebanon Rd
Campbellsville, KY 42718-9662
Phone (270) 789-6087

Other names 1

  • Taylor Regional Eye Specialist Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051221000527 KY Part B Supplier - Clinic/Group Practice 4880616622 Receives reassigned benefits from 89 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, KY; Campbellsville, KY; Lebanon, KY; Greensburg, KY; Caompbellsville, KY

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Taylor Regional Medical Groupllc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1619316239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189662",
            "telephone_number": "270-789-6087",
            "fax_number": "270-789-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189634",
            "telephone_number": "270-789-6087",
            "fax_number": "270-789-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR REGJIONAL MEDICAL GROUP,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "270-789-6087"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor Regional Eye Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.