Justin J Taylor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

394505 Issued in MN

Practice address

2020 Ridgeview Dr
International Falls, MN 56649-3829

Phone

(218) 283-2806

Fax

(218) 283-2177

NPI assigned

Jan 6, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1699314765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RIDGEVIEW DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566493829",
            "telephone_number": "218-283-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RIDGEVIEW DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566493829",
            "telephone_number": "218-283-2806",
            "fax_number": "218-283-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JUSTIN",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "394505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Skoog, PTA
• Tim Allen Smith, M.D.
• Nicholas Lee Starr, PSYD
• Anthony Christian Stone
• Doreen Evonne Swendsen, FNP
• The Duluth Clinic, LTD
• The Evangelical Lutheran Good Samaritan Society
• The Evangelical Lutheran Good Samaritan Society
• The Evangelical Lutheran Good Samaritan Society
• Cassie Thompson, OTR/L

• Assisted Living Facility in International Falls, MN
• Providers in International Falls, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.