Brina Bailey, PT

Key facts

NPI

1124259304

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

PT1619 (AR)

Practice address

707 Eldridge Ave E
Wynne, AR 72396-4032

Phone

(870) 208-8989

Fax

(870) 208-8107

NPI assigned

Aug 5, 2009

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• Boaz & Associates, Inc. Physical Therapy Clinic/Center · Wynne, AR · NPI 1518011816
  NPD (past)
• Crittenden Adult Care Services L.L.C. Adult Care Home Facility · West Memphis, AR · NPI 1659595551
  NPD (past) PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2009.

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1124259304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 ELDRIDGE AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964032",
            "telephone_number": "870-208-8989",
            "fax_number": "870-208-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ELDRIDGE AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964032",
            "telephone_number": "870-208-8989",
            "fax_number": "870-208-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "BRINA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Wynne, AR · Physical Therapist in Arkansas