Active NPI
Taylor Richardson
- Physician Assistant
- Longview, TX
National Provider Identifier
1831673789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12501
- Practice address
- 1300 N 6TH St
Longview, TX 75601-5567 - Phone
- (903) 232-8928
- NPI assigned
- Sep 17, 2018
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12501 | TX | Primary |
Addresses
Primary practice location
1300 N 6TH St
Longview, TX 75601-5567
Mailing address
2016 Cumberland Dr
Longview, TX 75601-3411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20250306003265 | CA | Practitioner - Physician Assistant | 1052658952 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12501 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Clinics of Longview | Current | Accepting new patients |
Locations
1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Longview, TX
- NPI 1407047863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1831673789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2016 CUMBERLAND DR",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756013411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 6TH ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015567",
"telephone_number": "903-232-8928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-17",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA12501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.