Mary E Taylor, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA001165 Issued in ME

Practice address

1012 Union St
Bangor, ME 04401-3060

Phone

(207) 945-5247

Fax

(207) 990-1248

NPI assigned

Jun 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1730315680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 UNION ST",
            "address_2": "SUITE 5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044018600",
            "telephone_number": "207-945-5247",
            "fax_number": "207-992-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-945-5247",
            "fax_number": "207-990-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001165",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA001165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434193199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric C Taylor, LCSW
• Ethan Ranger Taylor, O.D.
• Jennifer Wynne Taylor, PMHNP-BC
• Leeanne Taylor, MS, LADC
• Maria Elizabeth Taylor, LMSW-CC
• Mary Tedesco-Schneck, PNPC
• Ledor Friday Teekate
• Jacqueline Teele, CCP
• Nina Tekelenburg
• Lucus Temple, LMSW-CC

• Medical Physician Assistant in Bangor, ME
• Providers in Bangor, ME by specialty
• Medical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.