TIMOTHY BLAKE TAYLOR (NPI# 1356847743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356847743 |
| Entity Type | Individual |
| Full Name | TIMOTHY BLAKE TAYLOR |
| Practice Address |
2412 N Oak St Valdosta GA 31602-2567 |
| Practice Telephone | 2292441400 |
| Practice Fax Number | 2292445512 |
| Mailing Telephone | 2292441400 |
| Mailing Fax Number | 2292445512 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN235794 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700394749 | Timothy Dewaine Taylor | Pharmacist | 333 Laidley St Fl 3, Charleston, WV 25301-1614 | 2018-01-11 |
| 1518317007 | Timothy Taylor II | Physician Assistant | 140 Myrtle St, Girard, PA 16417-1624 | 2016-06-15 |
| 1144621384 | Timothy Leon Taylor | Counselor | 408 Mulberry St., Brownwood, TX 76801 | 2014-09-08 |
| 1538416490 | Timothy J Taylor | Registered Nurse | 14240 Emporia St, Brighton, CO 80602-5770 | 2012-08-10 |
| 1609159938 | Timothy W Taylor | Pharmacist | 4 Brittany Ct, Bloomington, IL 61704-8367 | 2011-09-22 |
| 1760625081 | Timothy Pattison Taylor Jr. | Emergency Medicine | 300 Big Mountain Road, Pelham, AL 35124-4102 | 2009-04-16 |
| 1205059532 | Timothy Neal Taylor | Counselor | 1315a Curt Dr, Champaign, IL 61821-1119 | 2007-04-11 |
| 1770620684 | Timothy N Taylor | Nurse Practitioner | 182 Sw Academy St Ste 304, Dallas, OR 97338-1900 | 2007-01-31 |
| 1033122593 | Timothy Scott Taylor | Physical Therapist | 5750 Alexis Rd, Sylvania, OH 43560-2349 | 2006-08-15 |
| 1033121322 | Timothy Osborn Taylor | Urology | 2330 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-13 |
| Street Address |
2412 N OAK ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093759011 | Matthew Allan Thomas | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2006-06-16 |
| 1992335855 | Lindsey Dickinson | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2020-01-20 |
| 1760028856 | Rachel Bennefield | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2019-11-23 |
| 1558846121 | Anna C Vaggalis | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-09-30 |
| 1972093185 | Jordan Ganas | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-05-14 |
| 1831607670 | Jessica Taylor | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-01-15 |
| 1730546326 | Charles Earl Watts Jr. | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2016-01-27 |
| 1679962807 | Caroline Hendley | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2015-01-12 |
| 1548662505 | Kathryn Marie Woltz | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2014-09-22 |
| 1003229568 | Chaeli Wisenbaker | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2014-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1609230069 | Kenneth Lindsey Kiser | Nurse Practitioner | 2209 Pineview Dr, Valdosta, GA 31602-7316 | 2016-04-11 |
| 1881023844 | Lori Gordon Tomlinson | Nurse Practitioner | 2301 N Ashley St, Valdosta, GA 31602-2620 | 2013-11-10 |
| 1144535840 | Keri L Amerson | Nurse Practitioner | 3321 N Valdosta Rd Ste B, Valdosta, GA 31602-1685 | 2010-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784788 | Natasha Allen | Nurse Practitioner | 4177 Pelham Cir, Lithonia, GA 30038-6140 | 2020-09-14 |
| 1336753920 | Henny P Brown | Nurse Practitioner | 3430 Ridgeland Pl, Alpharetta, GA 30004-8483 | 2020-09-01 |
| 1487267415 | Alethea Hope Tucker | Nurse Practitioner | 3685 Braselton Hwy Ste 100, Dacula, GA 30019-5920 | 2020-08-28 |
| 1952913808 | Carol Jo Wilbanks | Nurse Practitioner | 206 Crest Dr, Rock Spring, GA 30739-2041 | 2020-08-21 |
| 1164032017 | Myiesha Sellers Mcfarlin | Nurse Practitioner | 55 Sellers Ln, Baxley, GA 31513-2208 | 2020-08-05 |
| 1124645395 | Kisha Smalley | Nurse Practitioner | 117 Gambier Cv, Mcdonough, GA 30252-6273 | 2020-07-02 |
| 1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
| 1841819547 | Millicent Charte Duncan | Nurse Practitioner | 138 Parkview Rd, Savannah, GA 31419-9672 | 2020-04-13 |
| 1891329660 | Tracey Lynn Murray | Nurse Practitioner | 980 Johnson Ferry Rd Ste 880, Sandy Springs, GA 30342-1609 | 2020-03-02 |
| 1841820917 | Vedic Family Practice and Wellness | Nurse Practitioner | 1240 Upper Hembree Rd Ste E, Roswell, GA 30076-0914 | 2020-01-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.