Individual provider Active NPI

Bailey Jay Johnson-Rae, FNP-C

  • School Nurse Practitioner
  • Lakeway, TX
National Provider Identifier
1043966674
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Nurse PractitionerTaxonomy code 363LS0200X
License
363LS0200X Issued in TX
Practice address
1011 Corsaire St
Lakeway, TX 78734-4413
Phone
(512) 762-1601
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Nurse Practitioner 363LS0200X 363LS0200X TX Primary

Addresses

Primary practice location

1011 Corsaire St
Lakeway, TX 78734-4413

Mailing address

1011 Corsaire St
Lakeway, TX 78734-4413
Phone (512) 762-1601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240709002095 TX Practitioner - Nurse Practitioner 6406391903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

12005 Bee Caves Rd
V
Austin, TX 78738-6385
Phone (512) 225-0766

4303 Victory Dr
Austin, TX 78704-7507
Phone (512) 462-3627

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
363LS0200XTXMDSchool Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Apr 27, 2024 Accepting new patients
Owie Solutions LLC CurrentSince Sep 30, 2024 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Apr 27, 2024 Accepting new patients

Locations

4303 Victory Dr
Austin, TX 78704

351 Cypress Creek Rd
Ste 100
Cedar Park, TX 78613
Phone (512) 258-5533

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

503 Highway 1431
Ste 101
Marble Falls, TX 78654
Phone (830) 798-2400

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

3811 Bee Caves Rd
Ste 101
West Lake Hills, TX 78746
Phone (512) 443-3500

Interoperability endpoints

  • Direct secure messaging: bailey.johnson-rae.1@8042.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1043966674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 CORSAIRE ST",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344413",
            "telephone_number": "512-762-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CORSAIRE ST",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344413",
            "telephone_number": "512-762-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-RAE",
        "first_name": "BAILEY",
        "middle_name": "JAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "TX",
            "license": "363LS0200X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.