Individual provider Active NPI

Maureen Taylor, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1750002903
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
138892 Issued in TN
Practice address
1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2011
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 138892 TN Primary

Addresses

Primary practice location

1 Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

121 Beauchamp Oaks CT
Advance, NC 27006-8011
Phone (630) 863-4102

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Rusty1580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221227000411 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224408794 Reassigns benefits to 1 organization
I20250630001457 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224408794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Anesthesia Group PCGroup PAC ID 6901795830, 231 clinicians

Practice addresses (Care Compare)

1901 Clinch Ave
Knoxville, TN 37916-2307
Phone (865) 331-1111

990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 835-3560

Hospital & facility affiliations

  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138892TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Anesthesia Group, PC CurrentSince Jun 1, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Sep 16, 2022 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Dept 888089
Knoxville, TN 37995

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

Organizations & group practices 2

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 1

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1750002903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BEAUCHAMP OAKS CT",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270068011",
            "telephone_number": "630-863-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "138892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rusty1580",
            "affiliation": "N",
            "address_1": "1 Medical Center Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271570001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.