Individual provider Active NPI

Bruce Anthony Bailey, FNP-BC

  • Family Nurse Practitioner
  • Washington, GA
National Provider Identifier
1043747215
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219236 Issued in GA
Practice address
107 W Liberty St
Washington, GA 30673-1623
Phone
(706) 318-3158
NPI assigned
May 18, 2017
Last updated
May 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219236 GA Primary
Paramedic 146L00000X 3036 GA
Emergency Registered Nurse 163WE0003X 219236 GA

Addresses

Primary practice location

107 W Liberty St
Washington, GA 30673-1623

Mailing address

12 W Robert Toombs Ave
Washington, GA 30673-1662
Phone (706) 318-3158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171205001488 GA Practitioner - Nurse Practitioner 6507123254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1008 E Robert Toombs Ave
Washington, GA 30673-2089
Phone (706) 678-1633

3686 Wheeler Rd
Augusta, GA 30909-6520
Phone (706) 922-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3036GAMDParamedic
219236GAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent MD Healthcare Services, P.C. CurrentSince Aug 19, 2017 Accepting new patients
Urgent MD Healthcare Services, P.C. CurrentSince Aug 19, 2017 Accepting new patients

Locations

3686 Wheeler Rd
Augusta, GA 30909
Phone (706) 364-6471

1008 E Robert Toombs Ave
Washington, GA 30673
Phone (706) 678-1633

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1043747215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W ROBERT TOOMBS AVE",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306731662",
            "telephone_number": "706-318-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W LIBERTY ST",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306731623",
            "telephone_number": "706-318-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "BRUCE",
        "middle_name": "ANTHONY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "219236",
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "GA",
            "license": "3036",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "219236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, GA

Sources for this page

Verify at the official NPI Registry.