Active NPI
Mark P Taylor, MD
- Obstetrics & Gynecology Physician
- Mankato, MN
National Provider Identifier
1720067655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 28590
- Practice address
- 1230 E Main St
Mankato Clinic @ Main Street
Mankato, MN 56001-5066 - Phone
- (507) 625-1811
- NPI assigned
- Jan 10, 2006
- Last updated
- Jul 15, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 28590 | MN | Primary |
Addresses
Primary practice location
1230 E Main St
Mankato Clinic @ Main Street
Mankato, MN 56001-5066
Mailing address
1230 E Main St
PO Box 8674
Mankato, MN 56001-5066
Phone (507) 625-1811
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1652118 | Other | AMERICAS PPO MN | |
| 410849339 56001 C028 | Other | CHAMPUS | |
| 337385100 | Medicaid | MN | |
| NA2951023863 | Other | PREFERRED ONE MN | |
| HP25870 | Other | HEALTH PARTNERS MN | |
| 0702740 | Other | MEDICA MN | |
| 115554 | Other | UCARE MN | |
| 160025572 | Other | RR MEDICARE | |
| 49433TA | Other | BCBS MN | |
| 928549 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | marktaylor@mklt.allscriptsdirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28590 | MN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mankato Clinic Express, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- Mankato, MN
- NPI 1265626964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1720067655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "PO BOX 8674",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "MANKATO CLINIC @ MAIN STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "MARK",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MN",
"license": "28590",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO MN",
"identifier": "1652118",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "410849339 56001 C028",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337385100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE MN",
"identifier": "NA2951023863",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS MN",
"identifier": "HP25870",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA MN",
"identifier": "0702740",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MN",
"identifier": "115554",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "160025572",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "49433TA",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "928549",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "marktaylor@mklt.allscriptsdirect.net",
"affiliation": "N",
"endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1230 E Main St",
"address_2": "Mankato Clinic @ Main Street",
"city": "Mankato",
"state": "MN",
"country_code": "US",
"postal_code": "560015066",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.