TAYLOR BOTTARI (NPI# 1528452208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528452208 |
| Entity Type | Individual |
| Full Name | TAYLOR BOTTARI |
| Credential | PA-C |
| Practice Address |
208 W Dl Ingram Cannon Afb NM 88103 |
| Mailing Address |
2201 N Norris St Apt A Clovis NM 88101-9495 |
| Practice Telephone | 6026280665 |
| Mailing Telephone | 6026280665 |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
208 W DL INGRAM |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588111090 | Shannon Freshwater Long | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2016-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346747151 | Isabella Wolak | Pharmacist | 224 D L Ingram Blvd, Cannon Afb, NM 88103 | 2018-04-09 |
| 1225480544 | Stacey Tatro | Dentist | 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 | 2016-07-11 |
| 1871965673 | Chad Bryan Carter | Dentist | 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 | 2015-10-20 |
| 1740660836 | Terah Clifford | Dental Hygienist | 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 | 2015-06-03 |
| 1588071328 | Gretchen Evelynn Szymanski | Nurse Practitioner | Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 | 2014-07-14 |
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| 1366889487 | Jeremy Michael Strohmayer | General Practice | 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 | 2013-05-30 |
| 1356622401 | Matthew John Nielsen | Dentist | 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 | 2011-09-02 |
| 1689965485 | Bryan Wade Sixkiller | Optometrist | 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 | 2011-04-27 |
| 1386959500 | Alexandra Buford | Family Medicine | 208 W Casablanca Avenue, Cannon Airforce Base, NM 88103 | 2010-08-12 |
| Find all providers in zip 88103 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
| 1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
| 1164978540 | Deborah L Thorne | Physician Assistant | 111 W Lucero Ave Ste 6, Las Cruces, NM 88005-1829 | 2016-08-26 |
| 1134572738 | Weston Bradley Graff | Physician Assistant | 703 Christopher Dr, Belen, NM 87002-2617 | 2016-07-19 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1720445562 | Rebecca Gahan Brown | Physician Assistant | 150 N Roadrunner Pkwy, Las Cruces, NM 88011 | 2016-01-25 |
| 1508232240 | Edward R Watson | Physician Assistant | 2530 S Telshor Blvd Ste 207, Las Cruces, NM 88011-4975 | 2015-08-17 |
| 1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
| 1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
| 1760771067 | Kristal Anguiano | Physician Assistant | 2010 Industrial Park Rd., El Centro Family Health, Espanola, NM 87532-3600 | 2011-04-07 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88103 |
Please comment or provide details below to improve the information on TAYLOR BOTTARI.
| 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.