Individual provider Active NPI

Bruce E. Taylor, MD

  • Specialist
  • Lincoln, NE
National Provider Identifier
1790885903
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12891 Issued in NE
Practice address
1101 S 70TH St
# 203
Lincoln, NE 68510-4293
Phone
(402) 486-4035
Fax
(402) 486-3528
NPI assigned
Sep 25, 2006
Last updated
Jul 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12891 NE Primary

Addresses

Primary practice location

1101 S 70TH St
# 203
Lincoln, NE 68510-4293

Mailing address

1101 S 70TH St
# 203
Lincoln, NE 68510-4293
Phone (402) 486-4030

Other identifiers 1

IdentifierTypeStateIssuer
47074565613MedicaidNE

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 Medicine

State licenses

LicenseStateTypeSpecialty
12891NEMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1790885903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S 70TH ST",
            "address_2": "# 203",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104293",
            "telephone_number": "402-486-4030",
            "fax_number": "402-486-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S 70TH ST",
            "address_2": "# 203",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104293",
            "telephone_number": "402-486-4035",
            "fax_number": "402-486-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRUCE",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "12891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47074565613",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.