Individual provider Active NPI

Nicole Ashley Taylor, MD

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1649849639
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
29 South Paca St Family Medicine
Baltimore, MD 21201
Phone
(667) 214-1880
Fax
(410) 685-1861
NPI assigned
Jun 23, 2021
Reactivated
Dec 14, 2022
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

29 South Paca St Family Medicine
Baltimore, MD 21201

Mailing address

29 S Paca St
Baltimore, MD 21201
Phone (667) 214-1880

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1649849639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "667-214-1880",
            "fax_number": "410-685-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SOUTH PACA ST FAMILY MEDICINE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "667-214-1880",
            "fax_number": "410-685-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-14",
        "deactivation_date": "2022-12-08",
        "reactivation_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.