Individual provider Active NPI

Jacob Marshall Taylor, D.O., M.P.H.

  • Family Medicine Physician
  • Whitehall, MI
National Provider Identifier
1720367055
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022331 Issued in MI
Practice address
905 E Colby St Ste 100
Whitehall, MI 49461
Phone
(231) 728-5910
Fax
(231) 728-5918
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 5101022331 MI
Family Medicine Physician 207Q00000X 5101022331 MI Primary

Addresses

Primary practice location

905 E Colby St Ste 100
Whitehall, MI 49461

Mailing address

2734 E Apple Ave
Muskegon, MI 49442-4413
Phone (231) 798-4462

Other practice location 1

708 Fall St
Spring Lake, MI 49456
Phone (760) 908-2285

Other practice location 2

3443 Farr Rd
Fruitport, MI 49415-8779
Phone (231) 672-2900

Other practice location 3

708 Fall St
Spring Lake, MI 49456
Phone (760) 908-2285

Other identifiers 1

IdentifierTypeStateIssuer
1720367055MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190823000285 MI Practitioner - Family Practice 0143558577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians

Practice addresses (Care Compare)

905 E Colby St
Whitehall, MI 49461-1262
Phone (231) 728-5910

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022331MIMDMilitary Health Care Provider

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Oct 1, 2019 Accepting new patients
Mercy Physician Network Family Medicine CurrentSince May 27, 2021 Accepting new patients
Mercy Physician Network Family Medicine CurrentSince May 27, 2021 Accepting new patients
Mercy Health Partners CurrentSince Oct 1, 2019 Accepting new patients

Locations

3443 Farr Rd
Fruitport, MI 49415
Phone (231) 672-2900

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

905 E Colby St
Ste 100
Whitehall, MI 49461
Phone (231) 672-8050

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

Interoperability endpoints

  • Direct secure messaging: jtaylor42807@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 3

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": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1720367055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 E APPLE AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424413",
            "telephone_number": "231-798-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E COLBY ST STE 100",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "49461",
            "telephone_number": "231-728-5910",
            "fax_number": "231-728-5918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Fall St",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "MI",
            "postal_code": "49456",
            "country_code": "US",
            "telephone_number": "760-908-2285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3443 Farr Rd",
            "address_purpose": "LOCATION",
            "city": "Fruitport",
            "state": "MI",
            "postal_code": "494158779",
            "country_code": "US",
            "telephone_number": "231-672-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "708 Fall St",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "MI",
            "postal_code": "49456",
            "country_code": "US",
            "telephone_number": "760-908-2285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JACOB",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "MI",
            "license": "5101022331",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720367055",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, MI

Sources for this page

Verify at the official NPI Registry.