Heredeshee Latrice Taylor, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014223 Issued in IL

Practice address

3201 Holden Cir
Matteson, IL 60443

Phone

(773) 531-9794

NPI assigned

Apr 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Heredeshee Latrice Wilson Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Hyperbaric LLCGroup PAC ID 1456888627, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heredeshee.taylor.p1@direct.alegiscare.nextgenshare.com

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.

• Advanced Hyperbaric LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Hixson, TN
  • NPI 1326887928
  Medicare reassignment Care Compare group NPD
• Oasis Integrative Health LLC

  • Nurse Practitioner
  • Hixson, TN
  • NPI 1194693846
  Medicare reassignment NPD

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1669826657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 HOLDEN CIR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434435",
            "telephone_number": "773-531-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 HOLDEN CIR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "60443",
            "telephone_number": "773-531-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "HEREDESHEE",
        "middle_name": "LATRICE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEREDESHEE",
            "last_name": "WILSON",
            "middle_name": "LATRICE",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• T.O.C Incoorporation
• Rosanne Miller Tadsen, LCPC
• Kara Taliaferro, APRN
• Target Corporation
• Byron Louis Taylor I
• Sheri Temple
• Terri L Foster
• Marquetta Terry, M.S.
• The Dubois Douglas Centres
• The Foot and Ankle Wellness Center, LLC

• Family Nurse Practitioner in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.