Healthcare Provider Details

I. General information

NPI: 1194221192
Provider Name (Legal Business Name): TAYLOR JOHN NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14441 DUPONT CT STE 304
OMAHA NE
68144-2107
US

IV. Provider business mailing address

14441 DUPONT CT STE 304
OMAHA NE
68144-2107
US

V. Phone/Fax

Practice location:
  • Phone: 402-597-8775
  • Fax:
Mailing address:
  • Phone: 402-597-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2025-00446
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36200
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: