1. Home
  2. Directory
  3. Texas
  4. Southlake
  5. Plastic Surgery
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TAYLOR ANN CHISHOM MD MPH
NPI 1912520669
Plastic Surgery in Southlake, TX

Active since May 28, 2020PECOS Enrolled
415 E SOUTHLAKE BLVD STE 101, SOUTHLAKE, TX 76092(972) 636-4902(817) 421-8327 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 27, 2023, May 28, 2020 (2 updates tracked since 2020).

About Taylor Ann Chishom Md Mph NPPES

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

TAYLOR ANN CHISHOM MD MPH (NPI 1912520669) is an individual plastic surgery provider in Southlake, Texas, licensed in California (A185158) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912520669
Entity TypeIndividualFemale
Primary Taxonomy208200000X
Provider Legal NameTAYLOR ANN CHISHOMCredential: MD MPH
Location Address415 E SOUTHLAKE BLVD STE 101Southlake, TX 76092-6279
Mailing Address415 E Southlake Blvd Ste 101Southlake, TX 76092-6279 · (972) 636-4902 · Fax (817) 421-8327
Phone(972) 636-4902
Fax(817) 421-8327
Sole ProprietorNo
Enumeration DateMay 28, 2020
Last NPPES UpdateJune 22, 20262 updates tracked since enumeration
NPPES CertifiedJune 22, 2026
✔ NPI 1912520669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Licenses✔ Licensed in CA · A185158✔ Licensed in TX · W4780
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
415 E SOUTHLAKE BLVD STE 101, Southlake, TX 76092
Open in Google Maps ↗

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 Ann Chishom Md Mph 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76092 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
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 5

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

DR. CASEY L ANDERSON M.D.
Student in an Organized Health Care Education/Training Program
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
DR. JACOB CARLSON MD
Surgery
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
DR. GRANT ALEXANDER BOND M.D.
Surgery (Plastic and Reconstructive Surgery)
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080
BROOKS BRENDEN KELLY MD
Surgery (Plastic and Reconstructive Surgery)
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 809-3155
ARVIND MANISUNDARAM
Surgery (Plastic and Reconstructive Surgery)
415 E SOUTHLAKE BLVD STE 101
SOUTHLAKE, TX 76092
Tarrant County (817) 416-8080

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 Chishom's NPI number?

The NPI number for Taylor Chishom is 1912520669. It was assigned to this individual provider in the NPPES registry on May 28, 2020.

Where is Taylor Chishom located?

Taylor Chishom practices at 415 E Southlake Blvd Ste 101, Southlake, TX 76092. The listed phone number is (972) 636-4902.

What is Taylor Chishom's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Taylor Chishom enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Taylor Chishom was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days 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.