NPIMap

Organization Active NPI

Taylor Regional Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Campbellsville, KY
National Provider Identifier
1619981339
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TAYLOR REGIONAL MEDICAL GROUP, LLC
Practice address
100 Medical Park Dr Ste B
Campbellsville, KY 42718
Phone
(270) 465-0632
Fax
(270) 465-0539
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Mrs. Debra A Waldron
Title
Office Coordinator
Phone
(270) 465-3561

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

100 Medical Park Dr Ste B
Campbellsville, KY 42718

Mailing address

1698 Old Lebanon Rd
Campbellsville, KY 42718-3319
Phone (270) 789-6087

Other practice location 1

187 Will Walker Rd
Columbia, KY 42728-7436
Phone (270) 789-0632

Other identifiers 5

IdentifierTypeStateIssuer
7100225920MedicaidKY
7100466530MedicaidKY
7100962070MedicaidKY
7100011310MedicaidKY
7100814730MedicaidKY

Other names 1

  • Taylor Regional Orthopedic Group 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

Locations

100 Medical Park Dr
Campbellsville, KY 42718
Phone (270) 465-0632

Practitioners & affiliated clinicians

Practitioners 5

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1619981339",
    "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": "427183319",
            "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": "100 MEDICAL PARK DR STE B",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "42718",
            "telephone_number": "270-465-0632",
            "fax_number": "270-465-0539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Will Walker Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "KY",
            "postal_code": "427287436",
            "country_code": "US",
            "telephone_number": "270-789-0632",
            "fax_number": "270-465-0539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAYLOR REGIONAL MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "270-465-3561",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100225920",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100466530",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100962070",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100011310",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100814730",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor Regional Orthopedic Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Taylor Regional Orthopedic Group",
            "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 Dec 5, 2025; 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.