Individual provider Active NPI

Taylor McDowell

  • Family Nurse Practitioner
  • Fitzgerald, GA
National Provider Identifier
1720862170
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN291827 Issued in GA
Practice address
119 Norman Dorminy Dr Ste a
Fitzgerald, GA 31750-9069
Phone
(229) 423-5437
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN291827 GA Primary

Addresses

Primary practice location

119 Norman Dorminy Dr Ste a
Fitzgerald, GA 31750-9069

Mailing address

PO Box 749
Ocilla, GA 31774-0749
Phone (229) 468-9166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231206002458 GA Practitioner - Nurse Practitioner 5698124386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CCSG, IncGroup PAC ID 6103130745, 25 clinicians

Practice addresses (Care Compare)

116 Mimosa Dr
Thomasville, GA 31792-6605
Phone (229) 551-0083

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN291827GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CCSG, Inc. CurrentSince Nov 15, 2023 Accepting new patients

Locations

1 Sweet Bay Ct
Moultrie, GA 31768
Phone (229) 890-5305

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

116 Mimosa Dr
Thomasville, GA 31792
Phone (229) 551-0083

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1720862170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317740749",
            "telephone_number": "229-468-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NORMAN DORMINY DR STE A",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317509069",
            "telephone_number": "229-423-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN291827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

Verify at the official NPI Registry.