Active NPI
Robert E Taylor, M.D.
- Otolaryngology Physician
- Durham, NC
National Provider Identifier
1831143619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- NC 34749
- Practice address
- 4210 N Roxboro St
Suite 140
Durham, NC 27704-1874 - Phone
- (919) 620-7800
- Fax
- (919) 620-7807
- NPI assigned
- May 19, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | NC 34749 | NC | Primary |
| Otolaryngic Allergy Physician | 207YX0602X | NC34749 | NC |
Addresses
Primary practice location
4210 N Roxboro St
Suite 140
Durham, NC 27704-1874
Mailing address
4210 N Roxboro St
Suite 140
Durham, NC 27704-1874
Phone (919) 620-7800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890219V | Medicaid | NC | |
| 82148 | Other | NC | BLUE CROSS INDIVIDUAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC 34749 | NC | MD | Otolaryngology Physician |
| NC34749 | NC | MD | Otolaryngic Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bluhaven Health PA | Otolaryngology | Current | Accepting new patients |
Locations
4109 Wake Forest Rd
Ste 220
Raleigh, NC 27609
Phone (984) 370-2350
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260144000000",
"number": "1831143619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4210 N ROXBORO ST",
"address_2": "SUITE 140",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041874",
"telephone_number": "919-620-7800",
"fax_number": "919-620-7807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 N ROXBORO ST",
"address_2": "SUITE 140",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041874",
"telephone_number": "919-620-7800",
"fax_number": "919-620-7807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2009-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "NC 34749",
"primary": true
},
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "NC",
"license": "NC34749",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890219V",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INDIVIDUAL",
"identifier": "82148",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.