Individual provider Active NPI

Tamara Danielle Taylor, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1750649273
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2011023084 Issued in MO
Practice address
1120 S 6TH St Ste 110
Saint Louis, MO 63104-3602
Phone
(314) 533-1871
Fax
(314) 261-9469
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2011023084 MO Primary

Addresses

Primary practice location

1120 S 6TH St Ste 110
Saint Louis, MO 63104-3602

Mailing address

1120 S 6TH St Ste 110
Saint Louis, MO 63104-3602
Phone (314) 533-1871

Other practice location 1

10012 Kennerly Rd
Suite 203
Saint Louis, MO 63128-2197
Phone (314) 522-1399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2011023084MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The NP Advantage LLC Current Accepting new patients

Locations

1120 S 6th St
Ste 110
Saint Louis, MO 63104
Phone (314) 226-3105

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.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1750649273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S 6TH ST STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043602",
            "telephone_number": "314-533-1871",
            "fax_number": "314-261-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S 6TH ST STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043602",
            "telephone_number": "314-533-1871",
            "fax_number": "314-261-9469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10012 Kennerly Rd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282197",
            "country_code": "US",
            "telephone_number": "314-522-1399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TAMARA",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2011023084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.