Individual provider Active NPI

Taylor Sullivan Mara

  • Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1699419010
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-175897 Issued in AL
Practice address
810 Saint Vincents Dr
Birmingham, AL 35205-1601
Phone
(904) 372-3943
Fax
(904) 212-1618
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 1-175897 AL Primary

Addresses

Primary practice location

810 Saint Vincents Dr
Birmingham, AL 35205-1601

Mailing address

7751 Belfort Pkwy Ste 120
Jacksonville, FL 32256-6921
Phone (904) 372-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240517001012 AL Practitioner - Nurse Practitioner 2365883642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diabetes Management Partners LLCGroup PAC ID 9436435385, 66 clinicians

Practice addresses (Care Compare)

810 Saint Vincents Dr
Birmingham, AL 35205-1601
Phone (904) 372-3943

Hospital & facility affiliations

  • St Vincent'S Birmingham Hospital, Birmingham, AL, CCN 010056
  • St. Vincent'S East Hospital, Birmingham, AL, CCN 010011
  • St Vincent'S St Clair Hospital, Pell City, AL, CCN 010130
  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-175897ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Management Partners LLC Single Specialty CurrentSince Jun 24, 2024 Accepting new patients
Diabetes Management Partners LLC Single Specialty CurrentSince Jun 24, 2024 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

7751 Belfort Pkwy
Ste 120
Jacksonville, FL 32256

Organizations & group practices 2

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1699419010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566921",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SAINT VINCENTS DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051601",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARA",
        "first_name": "TAYLOR",
        "middle_name": "SULLIVAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-175897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.