Individual provider Active NPI

Tayler Marcolla, N.P.

  • Family Nurse Practitioner
  • Cameron, MO
National Provider Identifier
1831565811
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015021531 Issued in MO
Practice address
801 Euclid Ave
Cameron, MO 64429-2003
Phone
(816) 632-7254
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015021531 MO Primary

Addresses

Primary practice location

801 Euclid Ave
Cameron, MO 64429-2003

Mailing address

2204 Ridgecrest St
Chillicothe, MO 64601-3932
Phone (816) 262-6919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150928002734 MO Practitioner - Nurse Practitioner 0547578353 Reassigns benefits to 2 organizations
I20210830002430 KS Practitioner - Nurse Practitioner 0547578353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Marriott Medical CorpGroup PAC ID 2567531494, 63 clinicians

Practice addresses (Care Compare)

505 N Main St
Advantage Surgical and Wound Care
Eskridge, KS 66423-9646
Phone (785) 449-2294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NP Health of Mo LLC CurrentSince May 1, 2022 Accepting new patients
Robert Marriott Medical Corp CurrentSince Nov 1, 2024 Accepting new patients
KC Geriatrics LLC CurrentSince Dec 6, 2020 Accepting new patients
Ascentist Physicians Group, LLC PastSince Oct 15, 2015 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

505 N Main St
Eskridge, KS 66423
Phone (785) 449-2294

10 Lake Dr
Bonne Terre, MO 63628
Phone (573) 358-2800

801 Euclid Ave
Cameron, MO 64429
Phone (816) 632-7254

3001 E Elm St
Harrisonville, MO 64701
Phone (816) 380-6525

19200 E 37th Ter S
Independence, MO 64057
Phone (816) 335-3007

600 E Sunrise Dr
Raymore, MO 64083
Phone (816) 322-1991

9350 Green Park Rd
#A
Saint Louis, MO 63123
Phone (314) 845-0900

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.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1831565811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 RIDGECREST ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013932",
            "telephone_number": "816-262-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 EUCLID AVE",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292003",
            "telephone_number": "816-632-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOLLA",
        "first_name": "TAYLER",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015021531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

Verify at the official NPI Registry.