Individual provider Active NPI

Taylor Leigh Brezinka, PA

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1700549672
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5353 Issued in TN
Practice address
1211 Union Ave Ste 300
Memphis, TN 38104-6655
Phone
(901) 272-6018
Fax
(901) 201-4203
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 5353 TN Primary

Addresses

Primary practice location

1211 Union Ave Ste 300
Memphis, TN 38104-6655

Mailing address

1211 Union Ave
Memphis, TN 38104-6638

Other practice location 1

6401 Poplar Ave Ste 540
Memphis, TN 38119-4823
Phone (901) 478-0900

Other names 1

  • Taylor Leigh Nyland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230221002688 TN Practitioner - Physician Assistant 0345612339 Reassigns benefits to 1 organization
I20241126004358 MS Practitioner - Physician Assistant 0345612339 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients

Locations

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: taylorbrezinka@nmhs.medalliesdirect.net
  • Direct secure messaging: tnyland34333@mlh.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1700549672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655",
            "telephone_number": "901-272-6018",
            "fax_number": "901-201-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 Poplar Ave Ste 540",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194823",
            "country_code": "US",
            "telephone_number": "901-478-0900",
            "fax_number": "901-201-4203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREZINKA",
        "first_name": "TAYLOR",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2025-02-20",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "NYLAND",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.