Active NPI
Mark Taylor, DO
- Family Medicine Physician
- Sioux City, IA
National Provider Identifier
1770515579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01622
- Practice address
- 3718 Briar Path
Sioux City, IA 51104-1323 - Phone
- (712) 258-9073
- Fax
- (712) 258-9073
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01622 | IA | Primary |
Addresses
Primary practice location
3718 Briar Path
Sioux City, IA 51104-1323
Mailing address
3718 Briar Path
Sioux City, IA 51104-1323
Phone (712) 258-9073
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01622 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1770515579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3718 BRIAR PATH",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511041323",
"telephone_number": "712-258-9073",
"fax_number": "712-258-9073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3718 BRIAR PATH",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511041323",
"telephone_number": "712-258-9073",
"fax_number": "712-258-9073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "MARK",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "01622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.