Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Taylor Rae Root

Individual provider Physician Assistant · NPI 1396377883

Taylor Rae Root is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2020, 6 years ago. Practices with Baycare Clinic LLP, a 196-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1110 Kepler Dr
Green Bay, WI 54311-8306
Phone: (920) 288-5555
Fax: (920) 288-5550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1280 E Campus Dr, Mount Pleasant, MI 48858-3803 — (989) 774-2315

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5382 (WI)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1396377883
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 12, 2020
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Baycare Clinic Llp — 196 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Green Bay