NPIMap

Individual provider Active NPI

Jimmy W Dailey, MD

  • Family Medicine Physician
  • Canton, TX
National Provider Identifier
1073598199
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K3567 Issued in TX
Practice address
1108 S Buffalo St
Canton, TX 75103-2304
Phone
(903) 567-1910
Fax
(903) 567-1940
NPI assigned
Dec 13, 2005
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K3567 TX Primary

Addresses

Primary practice location

1108 S Buffalo St
Canton, TX 75103-2304

Mailing address

PO Box 788
Canton, TX 75103-0788
Phone (903) 567-1910

Other practice location 1

116 N Houston St
Edgewood, TX 75117-2500
Phone (903) 962-9419

Other identifiers 1

IdentifierTypeStateIssuer
111854905MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060214000089 TX Practitioner - Family Practice 3870508724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dailey Medical ClinicGroup PAC ID 5991858243, 3 clinicians

Practice addresses (Care Compare)

1108 S Buffalo
Canton, TX 75103-2304

1108 S Buffalo St
Canton, TX 75103-2304
Phone (903) 567-1910

116 N Houston St
Edgewood, TX 75117-2500
Phone (903) 600-6765

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.14 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
56.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions38
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K3567TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Out-Patient PLLC Family Medicine CurrentSince Apr 21, 2019 Accepting new patients
Dailey Medical Clinic Family Medicine CurrentSince Jun 22, 2009 Accepting new patients
Health at Home Services Inc Current Accepting new patients
Loh Elkhart LLC Past Accepting new patients
Dailey Medical Clinic Family Medicine Past Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients

Locations

1108 S Buffalo St
Canton, TX 75103
Phone (903) 567-1910

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Health at Home Services, IncCanton, TX, CCN 747828 Home health agency 5% Or Greater Direct Ownership Interest (33.3%)
Corporate Officer (25%)
Corporate Director (33.3%)		 Oct 24, 2018
Mar 13, 2018
Mar 13, 2018
Delta Hospice LLCFarmers Branch, TX, CCN 741597 Hospice Contracted Managing Employee Oct 14, 2023
Bridges HospiceFarmers Branch, TX, CCN 971701 Hospice Contracted Managing Employee Jul 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 8

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1073598199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751030788",
            "telephone_number": "903-567-1910",
            "fax_number": "903-567-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 S BUFFALO ST",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751032304",
            "telephone_number": "903-567-1910",
            "fax_number": "903-567-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 N Houston St",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "TX",
            "postal_code": "751172500",
            "country_code": "US",
            "telephone_number": "903-962-9419",
            "fax_number": "903-385-3340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "JIMMY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K3567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111854905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, TX

Sources for this page

Verify at the official NPI Registry.