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TAYLOR RAE PARK NP
NPI 1780454389
Nurse Practitioner in Florissant, MO

Active since January 04, 2024PECOS EnrolledAccepts Medicare Assignment
1225 GRAHAM RD STE C-1340, FLORISSANT, MO 63031(314) 953-8271 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 17, 2025, May 7, 2025, Nov 12, 2024 and 1 more (4 updates tracked since 2024).

About Taylor Rae Park Np NPPES

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

TAYLOR RAE PARK NP (NPI 1780454389) is an individual nurse practitioner in Florissant, Missouri, licensed in Missouri (2023037394) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Jerseyville, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1780454389
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameTAYLOR RAE PARKCredential: NP
Location Address1225 GRAHAM RD STE C-1340Florissant, MO 63031-8019
Mailing AddressPo Box 959354Saint Louis, MO 63195-9354 · (314) 953-8271 · Fax (314) 953-8272
Phone(314) 953-8271
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 4, 2024
Last NPPES UpdateSeptember 17, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
✔ NPI 1780454389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MO · 2023037394
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License 2016023237 (MO)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 209029415 (IL)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 2023037394 (MO)
1225 GRAHAM RD STE C-1340, Florissant, MO 63031
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Secondary Practice Location 1

Location 1903 S State StJerseyville, IL 62052-2344 · Phone (618) 498-2273 · Fax (618) 639-8100

Other Identifiers 2

Other209029415IL · Np License
Other16161910Caqh Id

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Taylor Rae Park Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951749373
PECOS Enrollment IDI20241120001784
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63031 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

MS. BESSEVELYN M. TABLES M.D.
Family Medicine
1225 GRAHAM RD STE C-1340
FLORISSANT, MO 63031
St. Louis County (314) 953-6801
KELLY MCKINNEY NP
Nurse Practitioner (Psychiatric/Mental Health)
1225 GRAHAM RD STE C-1340
FLORISSANT, MO 63031
St. Louis County (314) 953-6801

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 1780454389. It was assigned to this individual provider in the NPPES registry on January 4, 2024.

Where is Taylor Park located?

Taylor Park practices at 1225 Graham Rd Ste C-1340, Florissant, MO 63031. The listed phone number is (314) 953-8271.

What is Taylor Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Taylor Park enrolled in Medicare?

Yes. Taylor Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Taylor Park was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.