Individual provider Active NPI

Taylor F Lancaster, M.D.

  • Diagnostic Radiology Physician
  • Edmond, OK
National Provider Identifier
1760521645
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
23581 Issued in OK
Practice address
1705 Renaissance Blvd
Ste 100
Edmond, OK 73013-3041
Phone
(405) 285-6901
NPI assigned
Feb 6, 2007
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 23581 OK Primary

Addresses

Primary practice location

1705 Renaissance Blvd
Ste 100
Edmond, OK 73013-3041

Mailing address

1908 Alderbrook CT
Norman, OK 73072-3029
Phone (405) 285-6901

Other identifiers 8

IdentifierTypeStateIssuer
8J8682OtherTXTEXAS BCBS
178784001MedicaidAR
771100501OtherARARK BREASTCARE
200262360AMedicaidOK
N3130OtherTXTEXAS STATE LICENSE
1760521645OtherARAR BCBS
204961101MedicaidTX
E6107OtherARARK STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120924000520 OK Practitioner - Diagnostic Radiology 3274686373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Oklahoma College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NR Southwest Okc LLCGroup PAC ID 4981079373, 3 clinicians

Practice addresses (Care Compare)

9821 S May Ave
Suite B
Oklahoma City, OK 73159-7042
Phone (405) 645-5439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23581OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nerve Renewal Group LLC CurrentSince Dec 1, 2021 Accepting new patients
NR Southwest Okc LLC CurrentSince Jan 14, 2023 Accepting new patients
NR Norman LLC CurrentSince Dec 23, 2022 Accepting new patients
Renaissance Medical Management LLC Diagnostic Radiology PastSince Mar 12, 2024 Accepting new patients

Locations

3908 N Peniel Ave
Ste 450
Bethany, OK 73008

640 24th Ave SW
Norman, OK 73069
Phone (405) 295-7833

3705 NW 63rd St
Ste 101
Oklahoma City, OK 73116
Phone (405) 286-9903

3705 NW 63rd St
Ste 200
Oklahoma City, OK 73116
Phone (405) 463-6700

9821 S May Ave
Ste B
Oklahoma City, OK 73159
Phone (405) 631-4263

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1760521645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 ALDERBROOK CT",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730723029",
            "telephone_number": "405-285-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 RENAISSANCE BLVD",
            "address_2": "STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133041",
            "telephone_number": "405-285-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "TAYLOR",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "23581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BCBS",
            "identifier": "8J8682",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178784001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BREASTCARE",
            "identifier": "771100501",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200262360A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE",
            "identifier": "N3130",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "1760521645",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204961101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK STATE LICENSE",
            "identifier": "E6107",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.