Active NPI
Taylor Blake Little
- Independent Duty Medical Technicians
- Crestview, FL
National Provider Identifier
1902531130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- Practice address
- 1046 Limpkin St
Crestview, FL 32539-6758 - Phone
- (828) 270-6480
- NPI assigned
- Jul 21, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Primary |
Addresses
Primary practice location
1046 Limpkin St
Crestview, FL 32539-6758
Mailing address
1046 Limpkin St
Crestview, FL 32539-6758
Phone (828) 270-6480
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1902531130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1046 LIMPKIN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325396758",
"telephone_number": "828-270-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1046 LIMPKIN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325396758",
"telephone_number": "828-270-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LITTLE",
"first_name": "TAYLOR",
"middle_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-21",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1003X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Medical Technicians",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.