TAYLOR EVERSOLE (PA-C) – Physician Assistant, NPI 1336510783

TAYLOR EVERSOLE (PA-C) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 2015035763 (MO). The NPI Number for TAYLOR EVERSOLE (PA-C) is 1336510783

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
TAYLOR EVERSOLE (PA-C)
NPI
1336510783
Phone
(314) 268-2700
Address
1465 S GRAND BLVD
Enumeration Date
12 October 2015
Last Update Date
4 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3145775600
Graduation Year
2015 (11 years ago)
PAC ID
3870890767
Group Practice PAC ID
7012828163
Professional Enrollment ID
I20160321000303
Address ID
MO631041003SA1465XBLVD404

Contacts

FHIR Endpoint
https://fhis.ssmhc.com/fhir/api/FHIR/DSTU2/
Secure Messaging
teversole146366@direct-ehr-ssmhc.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:10State licenses:1Other namesUpdated within 12 months

1,854 PHYSICIAN ASSISTANT in MO

Provider Addresses for TAYLOR EVERSOLE (PA-C)

  • 1465 S GRAND BLVD

    SAINT LOUIS, MO 631041003

    Phone: (314) 268-2700

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-03-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160321000303IPhysician AssistantMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012828163View full group profile
NameSpecialtyState
Nurse PractitionerMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
-MO
Nurse PractitionerMO
Clinical PsychologistMO
P S Y C H I A T R YMO
Radiation OncologyMO
Diagnostic RadiologyMO
Clinical PsychologistMO

Reviews

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Frequently asked questions

Is there an official ID for TAYLOR EVERSOLE (PA-C) in U.S. healthcare records?
The official identifier for TAYLOR EVERSOLE (PA-C) is NPI 1336510783.
Is TAYLOR EVERSOLE (PA-C) still an active registrant?
TAYLOR EVERSOLE (PA-C) carries an active NPI according to the public dataset.
What clinical focus is listed for TAYLOR EVERSOLE (PA-C)?
At a glance, TAYLOR EVERSOLE (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Missouri is TAYLOR EVERSOLE (PA-C) registered?
Use Saint Louis, Missouri as the headline location for TAYLOR EVERSOLE (PA-C) here.
Can I trust this NPI listing for TAYLOR EVERSOLE (PA-C)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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