Taylor Keith Baucom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4861 Issued in SC

Practice address

3793 McDowell LN
Medical Park 2, Suite 100
Little River, SC 29566

Phone

(843) 390-0100

NPI assigned

Jun 9, 2023

Last updated

Jun 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbaucom25109@directmcleodehealth.org

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.

• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494
  Medicare reassignment Care Compare group
• McLeod Physician Associates II

  dba McLeod Urgent Care Center

  • Urgent Care Clinic/Center
  • Florence, SC
  • NPI 1104035492
  NPD
• McLeod Physician Associates II

  dba McLeod Orthopaedics - Florence

  • Orthopaedic Surgery Physician
  • Florence, SC
  • NPI 1922555739
  NPD
• McLeod Physician Associates II

  dba McLeod Family Medicine - Dillon

  • Family Medicine Physician
  • Dillon, SC
  • NPI 1568434249
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLeod Loris Seacoast Hospital

  dba Loris Community Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1891479929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 CAMPOBELLO DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "28110",
            "telephone_number": "704-221-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3793 MCDOWELL LN",
            "address_2": "MEDICAL PARK 2, SUITE 100",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "29566",
            "telephone_number": "843-390-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCOM",
        "first_name": "TAYLOR",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Little River, SC
• Providers in Little River, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.