Active NPI
Taylor Shore
- Pediatric Nurse Practitioner
- Austin, TX
National Provider Identifier
1821835141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 1142540
- Practice address
- 1201 W 38TH St
Austin, TX 78705-1006 - Phone
- (512) 324-1000
- NPI assigned
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 1142540 | TX | Primary |
Addresses
Primary practice location
1201 W 38TH St
Austin, TX 78705-1006
Mailing address
5400 W Parmer LN Apt 1917
Austin, TX 78727-3923
Phone (512) 934-3181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240912003508 | TX | Order and Referring Only - Nurse Practitioner | 2769922012 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1142540 | TX | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1821835141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 W PARMER LN APT 1917",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787273923",
"telephone_number": "512-934-3181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W 38TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051006",
"telephone_number": "512-324-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "TAYLOR",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-12",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "1142540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.