Individual provider Active NPI

Taylor B Laster, NP

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1982059929
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004699 Issued in AR
Practice address
5002 Cowhorn Creek Rd Ste 5033
Texarkana, TX 75503-9766
Phone
(903) 614-5005
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1135270 TX
Family Nurse Practitioner 363LF0000X A004699 AR Primary

Addresses

Primary practice location

5002 Cowhorn Creek Rd Ste 5033
Texarkana, TX 75503-9766

Mailing address

5002 Cowhorn Creek Rd Ste 5033a
Texarkana, TX 75503-9766
Phone (903) 614-5005

Other names 1

  • Taylor B Youngblood Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231002000858 TX Practitioner - Nurse Practitioner 1254785850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • McCurtain Memorial Hospital Hospital, Idabel, OK, CCN 371342
  • Howard Memorial Hospital Hospital, Nashville, AR, CCN 041311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1135270TXMDNurse Practitioner
A004699ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Nov 20, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 20, 2023 Accepting new patients
Christus Health Ark-la-Tex PastSince Sep 23, 2024 Accepting new patients

Locations

5002 Cowhorn Creek Rd
Ste 5033
Texarkana, TX 75503
Phone (903) 614-5005

5002 Cowhorn Creek Rd
Ste 5033A
Texarkana, TX 75503
Phone (903) 614-5005

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: tyoungblood340244@christushealth.direct-ci.net

Organizations & group practices 10

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 4

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1982059929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD STE 5033A",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD STE 5033",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTER",
        "first_name": "TAYLOR",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1135270",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "YOUNGBLOOD",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.