NPIMap

Individual provider Active NPI

Taylor Parks

  • Physician Assistant
  • Warwick, RI
National Provider Identifier
1689275455
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01666 Issued in RI
Practice address
17 Airport Rd
Warwick, RI 02889-1001
Phone
(401) 606-2520
Fax
(401) 384-7190
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7731 MA
Physician Assistant 363A00000X PA01666 RI Primary

Addresses

Primary practice location

17 Airport Rd
Warwick, RI 02889-1001

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Plainville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210201000606 MA Practitioner - Physician Assistant 8921412065 Reassigns benefits to 1 organization
I20240528001021 RI Practitioner - Physician Assistant 8921412065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

1084 Broadway
Raynham, MA 02767-1976
Phone (508) 822-9400

11 Commerce Way
Suite 5
Johnston, RI 02919-4613
Phone (401) 606-2610

12 Bluebird Rd
Wellesley, MA 02481-3503
Phone (774) 309-4129

1360 W Main Rd
Middletown, RI 02842-6301
Phone (401) 606-3110

17 Airport Rd
Warwick, RI 02889-1001
Phone (401) 606-2520

55 Tollgate Hill Farm Rd
Warwick, RI 02886-4495
Phone (401) 889-5906

642 Metacom Ave
Warren, RI 02885-2350
Phone (781) 867-2050

730 Madison St
Wrentham, MA 02093-1640
Phone (781) 867-2050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01666RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Jun 5, 2024 Accepting new patients
Convenientmd LLC Urgent Care Past Accepting new patients

Locations

1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110

17 Airport Rd
Warwick, RI 02889
Phone (401) 606-2520

Organizations & group practices 4

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 5

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1689275455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 AIRPORT RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028891001",
            "telephone_number": "401-606-2520",
            "fax_number": "401-384-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7731",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Plainville",
            "affiliation": "N",
            "address_1": "86 Taunton St",
            "city": "Plainville",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027622131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.