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TAYLOR PARK
NPI 1477254340
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since March 16, 2023PECOS Enrolled
1015 NW 22ND AVE, PORTLAND, OR 97210(503) 413-7711 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Apr 15, 2024, Mar 16, 2023 (2 updates tracked since 2023).

About Taylor Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAYLOR PARK (NPI 1477254340) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477254340
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTAYLOR PARK
Location Address1015 NW 22ND AVEPortland, OR 97210-3025
Mailing Address1015 Nw 22nd AvePortland, OR 97210-3025 · (503) 413-7711
Phone(503) 413-7711
Sole ProprietorNo
Enumeration DateMarch 16, 2023
Last NPPES UpdateApril 15, 20242 updates tracked since enumeration
NPPES CertifiedApril 15, 2024
✔ NPI 1477254340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1015 NW 22ND AVE, Portland, OR 97210
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Taylor Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TSYRIA SHIANN TANG DO
Internal Medicine
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-7036
MARK A CRISLIP
Internal Medicine (Infectious Disease)
1015 NW 22ND AVE, R200
PORTLAND, OR 97210
Multnomah County (503) 413-8258
COLTON PATRICK BONEY DO
Student in an Organized Health Care Education/Training Program
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-7711
NICKOLAS ROCKENBACK MD
Student in an Organized Health Care Education/Training Program
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-7711
CAROLYN N RHETT MD
Emergency Medicine
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-7260
BRIAN BATTALIA MD
Internal Medicine
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 464-9034
DR. JUDITH ANN RAY M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-8259
JENELLE LYNN STINSON PHARMD
Pharmacist
1015 NW 22ND AVE
PORTLAND, OR 97210
Multnomah County (503) 413-7008

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Taylor Park's NPI number?

The NPI number for Taylor Park is 1477254340. It was assigned to this individual provider in the NPPES registry on March 16, 2023.

Where is Taylor Park located?

Taylor Park practices at 1015 NW 22nd Ave, Portland, OR 97210. The listed phone number is (503) 413-7711.

What is Taylor Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Taylor Park enrolled in Medicare?

Yes. Taylor Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Taylor Park was last updated on April 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.