Individual provider Active NPI

Westly Adrian Bailey, MD

  • Sports Medicine (Family Medicine) Physician
  • Suwanee, GA
National Provider Identifier
1053596296
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
063165 Issued in GA
Practice address
3890 Johns Creek Pkwy
Ste 230
Suwanee, GA 30024-1284
Phone
(770) 623-1331
Fax
(770) 623-5674
NPI assigned
Jan 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 002629 GA
Family Medicine Physician 207Q00000X 063165 GA
Sports Medicine (Family Medicine) Physician 207QS0010X 63165 GA
Sports Medicine (Family Medicine) Physician 207QS0010X 063165 GA Primary

Addresses

Primary practice location

3890 Johns Creek Pkwy
Ste 230
Suwanee, GA 30024-1284

Mailing address

3890 Johns Creek Pkwy
Ste 230
Suwanee, GA 30024-1284
Phone (770) 623-1331

Other identifiers 1

IdentifierTypeStateIssuer
002629OtherGARESIDENCY TRAINING PERMIT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address westlybailey@pnfm.allscriptsdirect.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110823000485 GA Practitioner - Family PracticePractitioner - Sports Medicine 2961672308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Duke University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Qcpi-Villagemd PC 76 clinicians
Select Rehabilitation, LLC 1,935 clinicians

Practice addresses (Care Compare)

1805 Parke Plaza Cir
Suite 101
Stone Mountain, GA 30087-3646
Phone (770) 879-0436

189 Medical Way
Suite a
Riverdale, GA 30274-4905
Phone (770) 960-8855

235 Medical Blvd
Stockbridge, GA 30281-7218
Phone (770) 960-8855

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Kennesaw, GA, CCN 117027
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Emory Hillandale Hospital Hospital, Lithonia, GA, CCN 110226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63165GAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perimeter North Family Practice LLC Family Medicine PastSince Aug 5, 2012 Accepting new patients
Advanced Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: westlybailey@pnfm.allscriptsdirect.net
  • Direct secure messaging: westly.bailey.1@21533.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1053596296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 JOHNS CREEK PKWY",
            "address_2": "STE 230",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241284",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 JOHNS CREEK PKWY",
            "address_2": "STE 230",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241284",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "WESTLY",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "002629",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "063165",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "63165",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "063165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENCY TRAINING PERMIT",
            "identifier": "002629",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "westlybailey@pnfm.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "3890 Johns Creek Pkwy",
            "address_2": "Ste 230",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300241284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.