Individual provider Active NPI

Malcolm P Taylor, M.D.

  • Cardiovascular Disease Physician
  • Flowood, MS
National Provider Identifier
1720092414
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
08196 Issued in MS
Practice address
1040 River Oaks Dr Ste 100
Flowood, MS 39232-9531
Phone
(601) 933-5417
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 08196 MS Primary

Addresses

Primary practice location

1040 River Oaks Dr Ste 100
Flowood, MS 39232-9531

Mailing address

1040 River Oaks Dr Ste 100
Flowood, MS 39232-9531
Phone (601) 933-5417

Other identifiers 1

IdentifierTypeStateIssuer
0016866MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address malcolm.taylor.1@4695.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000697 MS Practitioner - Cardiovascular Disease (Cardiology) 4880617562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
08196MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Careplus Lakeview Family Medicine CurrentSince Mar 1, 2018 Accepting new patients
Reservoir Family Medical Clinic, PA Current Accepting new patients
River Oaks Management Company, LLC CurrentSince Mar 1, 2018 Accepting new patients
River Oaks Management Company LLC Current Accepting new patients
Brandon Hma LLC Past Accepting new patients

Locations

348 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-9430

130 Southpointe Dr
Ste D
Byram, MS 39272

1040 River Oaks Dr
Ste 100
Jackson, MS 39232
Phone (601) 933-5417

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1720092414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329531",
            "telephone_number": "601-933-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329531",
            "telephone_number": "601-933-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MALCOLM",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "08196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016866",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "malcolm.taylor.1@4695.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1040 River Oaks Dr Ste 100",
            "city": "Flowood",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392329531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.