NPIMap

Organization Active NPI

Dr Joan Wynn Taylor LLC

  • General Practice Physician
  • Mt Pleasant, SC
National Provider Identifier
1972586394
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
12593 Issued in SC
Legal business name
DR JOAN WYNN TAYLOR LLC
Doing business as
Joan Wynn Taylor, M. D. Gen. Med. Practice
Practice address
3070 N Highway 17
Suite 200
Mt Pleasant, SC 29466-9300
Phone
(843) 216-0080
Fax
(843) 216-0082
NPI assigned
Nov 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Mrs. Joan Wynn Taylor, M. D.
Title
Chief Medical Officer
Phone
(843) 216-0080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X SC12593 SC
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X 12593 SC Primary

Addresses

Primary practice location

3070 N Highway 17
Suite 200
Mt Pleasant, SC 29466-9300

Mailing address

3070 N Highway 17
Suite 200
Mt Pleasant, SC 29466-9300
Phone (843) 216-0080

Other identifiers 1

IdentifierTypeStateIssuer
GP4112MedicaidSC

Other names 1

  • Joan Wynn Taylor, M. D. Gen. Med. Practice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1972586394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300",
            "telephone_number": "843-216-0080",
            "fax_number": "843-216-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300",
            "telephone_number": "843-216-0080",
            "fax_number": "843-216-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JOAN WYNN TAYLOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "WYNN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "843-216-0080",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "SC12593",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "SC",
            "license": "12593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4112",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joan Wynn Taylor, M. D. Gen. Med. Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.