NPIMap

Individual provider Active NPI

Jessica Elizabeth Taylor, M.D.

  • Surgery Physician
  • Gainesville, FL
National Provider Identifier
1790046704
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME146543 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-5345
Phone
(352) 265-0761
Fax
(352) 265-1060
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2018-01597 NC
Surgery Physician 208600000X LL34658 SC
Surgery Physician 208600000X 56289 TN
Surgical Critical Care Physician 2086S0102X ME146543 FL
Surgery Physician 208600000X ME146543 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-5345

Mailing address

2511 Delaney Ave
Wilmington, NC 28403-6003
Phone (910) 667-9402

Other practice location 1

1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone (910) 667-9402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171130003211 TN Practitioner - General Surgery 2567684459 Reassigns benefits to 1 organization
I20200813002139 FL Practitioner - General Surgery 2567684459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME146543FLMDSurgery Physician
2018-01597NCMDSurgery Physician
56289TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Aug 10, 2020 Accepting new patients
Florida Clinical Practice Association Inc Surgery CurrentSince Aug 10, 2020 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Wellmont Medical Associates Inc Surgery CurrentSince Jun 1, 2020 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

130 W Ravine Rd
Ste 3A
Kingsport, TN 37660
Phone (423) 224-3220

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jshue467980@direct.shands.ufl.edu
  • Direct secure messaging: jessica.taylor@ugs.directbygreenway.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1790046704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036003",
            "telephone_number": "910-667-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326105345",
            "telephone_number": "352-265-0761",
            "fax_number": "352-265-1060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 New Hanover Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035345",
            "country_code": "US",
            "telephone_number": "910-667-9402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2018-01597",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL34658",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "56289",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME146543",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME146543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.