NPIMap

Individual provider Active NPI

Timothy Nickolas Taylor, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1871588335
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
K7917 Issued in TX
Practice address
111 Dallas St
Emergency Room
San Antonio, TX 78205-1201
Phone
(210) 614-0180
Fax
(210) 615-7170
NPI assigned
Sep 12, 2005
Last updated
Jan 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X K7917 TX Primary

Addresses

Primary practice location

111 Dallas St
Emergency Room
San Antonio, TX 78205-1201

Mailing address

PO Box 12740
Westminster, CA 92685-2740
Phone (562) 809-3527

Other identifiers 3

IdentifierTypeStateIssuer
096397705MedicaidTX
096397703MedicaidTX
8K7853OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K7917TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River City Pediatric Emergency Physicians, PLLC Past Accepting new patients
Waco Cardiology Associates Past Accepting new patients
River City Nurse Management LLC Emergency Medical Services Past Accepting new patients
San Antonio Epa, PA PastSince Jan 1, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1871588335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12740",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852740",
            "telephone_number": "562-809-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DALLAS ST",
            "address_2": "EMERGENCY ROOM",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051201",
            "telephone_number": "210-614-0180",
            "fax_number": "210-615-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TIMOTHY",
        "middle_name": "NICKOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "K7917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096397705",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096397703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8K7853",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.