Individual provider Active NPI

John Scott Taylor, M.D.

  • Emergency Medicine Physician
  • Puyallup, WA
National Provider Identifier
1770689911
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00048095 Issued in WA
Practice address
407 14TH Ave SE
Puyallup, WA 98372-3770
Phone
(253) 697-1848
NPI assigned
Sep 15, 2006
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301074254 MI
Emergency Medicine Physician 207P00000X MD00048095 WA Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 074254 MI

Addresses

Primary practice location

407 14TH Ave SE
Puyallup, WA 98372-3770

Mailing address

971 11TH Lane Fi
Fox Island, WA 98333-9643
Phone (253) 238-0567

Other identifiers 3

IdentifierTypeStateIssuer
0B51090OtherMIBLUE SHIELD
104441890MedicaidMI
4786075MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20071031000315 WA Practitioner - Emergency Medicine 7719902501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Virginia Commonwealth Univ School of Dentistry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Washington Emergency Physicians PLLCGroup PAC ID 0749514735, 78 clinicians

Practice addresses (Care Compare)

14815 Pacific Ave S
Tacoma, WA 98444-4654
Phone (253) 697-8660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
074254MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Rainier Emergency Physicians, PLLC Emergency Medicine CurrentSince Jun 1, 2007 Accepting new patients

Locations

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

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

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1770689911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 11TH LANE FI",
            "city": "FOX ISLAND",
            "state": "WA",
            "postal_code": "983339643",
            "telephone_number": "253-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723770",
            "telephone_number": "253-697-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JOHN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301074254",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00048095",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "074254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0B51090",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104441890",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4786075",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.