Individual provider Active NPI

Gavin Martin Taylor, MD

  • Family Medicine Physician
  • Royal Oak, MI
National Provider Identifier
1962067223
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301506679 Issued in MI
Practice address
950 N Main St
Royal Oak, MI 48067-1840
Phone
(248) 543-8111
NPI assigned
May 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Family Medicine Physician 207Q00000X 4301506679 MI Primary

Addresses

Primary practice location

950 N Main St
Royal Oak, MI 48067-1840

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Other practice location 1

7330 N Canton Center Rd Ste 111
Canton, MI 48187-1538
Phone (734) 454-8001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gtaylor4086395@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220913000827 MI Practitioner - Family Practice 3274868187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

950 N Main St
Corewell Health Family Medicine
Royal Oak, MI 48067-1840
Phone (248) 543-8111

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Sep 12, 2022 Accepting new patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Sep 12, 2022 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

7330 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

7330 N Canton Center Rd
Ste 111
Canton, MI 48187
Phone (734) 454-2808

950 N Main St
Royal Oak, MI 48067
Phone (248) 543-8111

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: gtaylor1258486@epic00.shdirect.org

Organizations & group practices 3

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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1962067223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N MAIN ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671840",
            "telephone_number": "248-543-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7330 N Canton Center Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481871538",
            "country_code": "US",
            "telephone_number": "734-454-8001",
            "fax_number": "248-849-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GAVIN",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301506679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gtaylor4086395@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "7330 N Canton Center Rd Ste 111",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481871538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.