Basic Information
Provider Information | |||||||||
NPI: | 1730273293 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | TAYLOR | ||||||||
FirstName: | SARAH | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
Address2: | SUITE 210 MS5003 | ||||||||
City: | WESTWOOD | ||||||||
State: | KS | ||||||||
PostalCode: | 662052005 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9135886029 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
Address2: | SUITE 210 MS 5003 | ||||||||
City: | WESTWOOD | ||||||||
State: | KS | ||||||||
PostalCode: | 662052005 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9135886029 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/02/2006 | ||||||||
LastUpdateDate: | 05/12/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 04-16882 | KS | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
ID | Type | State | Issuer | Description | 201364403 | 05 | MO |   | MEDICAID | 08410037 | 01 | MO | BCBS KC | OTHER | 100195430A | 05 | KS |   | MEDICAID | 627180 | 01 | KS | FIRSTGUARD | OTHER |