Individual provider Active NPI

Robert E Taylor, M.D.

  • Otolaryngology Physician
  • Durham, NC
National Provider Identifier
1831143619
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
NC 34749 Issued in NC
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

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
890219VMedicaidNC
82148OtherNCBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000682 NC Practitioner - Otolaryngology 6305933722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NC 34749NCMDOtolaryngology Physician
NC34749NCMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bluhaven Health PA Otolaryngology CurrentSince May 3, 2024 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

Verify at the official NPI Registry.