Individual provider Active NPI

Timothy Bailey, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1063013423
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
068623-23 Issued in NH
Practice address
2 S Park St
Lebanon, NH 03766-1384
Phone
(603) 865-7157
NPI assigned
Nov 3, 2020
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 068623-23 NH Primary

Addresses

Primary practice location

2 S Park St
Lebanon, NH 03766-1384

Mailing address

2 S Park St
Lebanon, NH 03766-1384
Phone (603) 865-7157

Other practice location 1

273 County Rd
New London, NH 03257-5736
Phone (603) 526-2911

Other practice location 2

11 John Stark Hwy
Newport, NH 03773-1807
Phone (603) 863-4100

Other practice location 3

36 Clinton St
Concord, NH 03301-2359
Phone (603) 271-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20210720003242 NH Practitioner - Nurse Practitioner 7517360142 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 S Park St
Lebanon, NH 03766-1384
Phone (603) 865-7157

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068623-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The New London Hospital Association, Inc. CurrentSince Jun 14, 2023 Accepting new patients
The New London Hospital Association, Inc. CurrentSince Jun 14, 2023 Accepting new patients
The New London Hospital Association, Inc. Current Accepting new patients
State of New Hampshire CurrentSince Apr 13, 2021 Accepting new patients
Pine Psychiatry Psychiatric/Mental Health CurrentSince Jun 8, 2023 Accepting new patients
State of New Hampshire CurrentSince Apr 13, 2021 Accepting new patients

Locations

36 Clinton St
Concord, NH 03301
Phone (603) 271-5075

2 S Park St
Lebanon, NH 03766
Phone (603) 863-8956

273 County Rd
New London, NH 03257
Phone (603) 526-5215

11 John Stark Hwy
Newport, NH 03773
Phone (603) 526-5203

Interoperability endpoints

  • Direct secure messaging: tbailey139408@direct.dartmouth-hitchcock.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1063013423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S PARK ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661384",
            "telephone_number": "603-865-7157",
            "fax_number": "603-709-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S PARK ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661384",
            "telephone_number": "603-865-7157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 County Rd",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "NH",
            "postal_code": "032575736",
            "country_code": "US",
            "telephone_number": "603-526-2911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 John Stark Hwy",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "NH",
            "postal_code": "037731807",
            "country_code": "US",
            "telephone_number": "603-863-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033012359",
            "country_code": "US",
            "telephone_number": "603-271-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "TIMOTHY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "068623-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.