NPIMap

Organization Active NPI

Taylor and Clifton Family Healthcare

  • Rural Health Clinic/Center
  • Corbin, KY
National Provider Identifier
1700425675
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
TAYLOR AND CLIFTON FAMILY HEALTHCARE
Practice address
14 Moonbow PLZ Ste 2
Corbin, KY 40701-8910
Phone
(606) 524-7510
NPI assigned
Dec 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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

Authorized official

Name
Gloria Taylor, APRNNPI 1356326896
Title
Member
Phone
(606) 524-7510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

14 Moonbow PLZ Ste 2
Corbin, KY 40701-8910

Mailing address

14 Moonbow PLZ Ste 2
Corbin, KY 40701-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200306001354 KY Part B Supplier - Clinic/Group Practice 5991133803 Receives reassigned benefits from 7 practitioners
Practice locations: Corbin, KY
O20200330002562 KY Part A Provider - Rural Health Clinic 5991133803 Practice locations: Corbin, KY

Rural health clinic certification: CCN B03818

Legal name
TAYLOR AND CLIFTON FAMILY HEALTHCARE
Doing business as
TAYLOR FAMILY HEALTHCARE PLLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 4, 2020
Last certification
Jun 4, 2020
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
14 Moonbow PLZ
Ste 2
Corbin, KY 40701-8910

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2177398Taylor Family Healthcare14 Moonbow Plaza, Suite 2, Corbin, KY 40701Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gloria J Taylor Individual 5% Or Greater Direct Ownership Interest Oct 24, 2019 50%
Corporate OfficerVice President Oct 24, 2019
W-2 Managing EmployeeNurse Practitioner Oct 24, 2019 50%
Operational/Managerial ControlVice President Oct 24, 2019
Vernon E Taylor Individual 5% Or Greater Direct Ownership Interest May 1, 2020 50%
Corporate OfficerPresident Oct 24, 2019
W-2 Managing Employee Oct 24, 2019 50%
Operational/Managerial ControlPresident Oct 24, 2019

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Gloria Jean Taylor, APRN
    • Nurse Practitioner
    • Corbin, KY
    • NPI 1356326896

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership
  • Vernon Eugene Taylor Jr., APRN
    • Family Nurse Practitioner
    • Gray, KY
    • NPI 1326380304

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577145600000",
    "number": "1700425675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MOONBOW PLZ STE 2",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MOONBOW PLZ STE 2",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018910",
            "telephone_number": "606-524-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR AND CLIFTON FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-24",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "606-524-7510",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.