Individual provider Active NPI

Taylor Rae Vos, PA-C

  • Physician Assistant
  • Allendale, MI
National Provider Identifier
1629700976
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012167 Issued in MI
Practice address
11160 WJ Presley Pkwy Ste 101
Allendale, MI 49401-8075
Phone
(616) 895-2000
Fax
(616) 895-2009
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 5601012167 MI Primary

Addresses

Primary practice location

11160 WJ Presley Pkwy Ste 101
Allendale, MI 49401-8075

Mailing address

11160 W.J. Presley Pkwy
Suite 101
Allendale, MI 49401
Phone (616) 895-2000

Other names 1

  • Taylor Rae Tepper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925001402 MI Practitioner - Physician Assistant 6103367545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allendale Family PracticeGroup PAC ID 0244289775, 5 clinicians

Practice addresses (Care Compare)

11315 Edgewater Dr
Allendale, MI 49401-9396
Phone (616) 895-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012167MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: taylor.vos.1@28510.direct.athenahealth.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1629700976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 W.J. PRESLEY PKWY",
            "address_2": "SUITE 101",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "49401",
            "telephone_number": "616-895-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WJ PRESLEY PKWY STE 101",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018075",
            "telephone_number": "616-895-2000",
            "fax_number": "616-895-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOS",
        "first_name": "TAYLOR",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "TEPPER",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allendale, MI

Sources for this page

Verify at the official NPI Registry.