Individual provider Active NPI

Bradley Shane Taylor, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1922529080
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011419 Issued in KY
Practice address
5925 Old Hwy 60 West
Suite D
Paducah, KY 42001
Phone
(270) 228-0118
Fax
(270) 228-0120
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209016137 IL
Family Nurse Practitioner 363LF0000X 3011419 KY Primary

Addresses

Primary practice location

5925 Old Hwy 60 West
Suite D
Paducah, KY 42001

Mailing address

5925 Old Hwy 60
Paducah, KY 42001
Phone (270) 228-0118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20180207000907 KY Practitioner - Nurse Practitioner 2264708643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Southern Pain and Rehabilitation IncGroup PAC ID 6406271436, 6 clinicians

Practice addresses (Care Compare)

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

5925 Old Hwy 60 W D
Paducah, KY 42001
Phone (270) 228-0118

Hospital & facility affiliations

  • Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
  • Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Pain and Rehabilitation Inc Family CurrentSince Sep 28, 2020 Accepting new patients
Elite Anesthesia LLC PastSince Jul 22, 2025 Accepting new patients

Locations

4645 Village Square Dr
Ste C
Paducah, KY 42001
Phone (270) 228-0118

5925 US Highway 60 W
Ste D
Paducah, KY 42001
Phone (270) 276-6502

Interoperability endpoints

  • Direct secure messaging: bradley.taylor@3626.securemail.prognocis.com

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1922529080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 OLD HWY 60",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-228-0118",
            "fax_number": "270-228-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 OLD HWY 60 WEST",
            "address_2": "SUITE D",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-228-0118",
            "fax_number": "270-228-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRADLEY",
        "middle_name": "SHANE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016137",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.