Individual provider Active NPI

Rohmoya Shantea Bailey, PT, DPT

  • Physical Therapist
  • Lincoln, ME
National Provider Identifier
1104416981
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5521 Issued in ME
Practice address
36 Workman Ter
Lincoln, ME 04457-1162
Phone
(207) 794-6025
NPI assigned
Jan 25, 2021
Last updated
Jan 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12518 CT
Physical Therapist 225100000X P100210E NC
Physical Therapist 225100000X EL05229 NH
Physical Therapist 225100000X PT5521 ME Primary

Addresses

Primary practice location

36 Workman Ter
Lincoln, ME 04457-1162

Mailing address

655 S Willow St Ste 128
Manchester, NH 03103-5723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT5521MEMDPhysical Therapist
P100210ENCMDPhysical Therapist
EL05229NHMDPhysical Therapist
12518CTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1104416981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST STE 128",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WORKMAN TER",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044571162",
            "telephone_number": "207-794-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ROHMOYA",
        "middle_name": "SHANTEA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12518",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P100210E",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "EL05229",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.