Active NPI
Jake Hamilton Bayless, DO
- Hospitalist Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2023-03317
- Practice address
- 10905 Providence Rd W
Ste G200
Charlotte, NC 28277-1538 - Phone
- (980) 488-4900
- Fax
- (980) 488-4905
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL40693 | SC | |
| Hospitalist Physician | 208M00000X | 2023-03317 | NC | Primary |
Addresses
Primary practice location
10905 Providence Rd W
Ste G200
Charlotte, NC 28277-1538
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 488-4900
Other practice location 1
853 N Church St Ste 510
Spartanburg, SC 29303-3077
Phone (864) 560-6193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7597
Hospital & facility affiliations
- Novant Health Ballantyne Medical Center
- Novant Health Presbyterian Medical Center
- Novant Health Matthews Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL40693 | SC | MD | Family Medicine Physician |
| 2023-03317 | NC | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Hospitalist | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Ballantyne Medical Center LLC | Past | Accepting new patients |
Locations
10905 Providence Rd W
Ste G200
Charlotte, NC 28277
Phone (980) 488-4900
1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- jbayless1327413@direct.novanthealth.org
Organizations & group practices 4
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Hospitalist Physician
- Huntersville, NC
- NPI 1578904850
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1740998020
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1740998020
-
- General Acute Care Hospital
- Matthews, NC
- NPI 1063463156
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1124558135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "980-488-4900",
"fax_number": "980-488-4905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10905 PROVIDENCE RD W",
"address_2": "STE G200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282771538",
"telephone_number": "980-488-4900",
"fax_number": "980-488-4905"
}
],
"practiceLocations": [
{
"address_1": "853 N Church St Ste 510",
"address_purpose": "LOCATION",
"city": "Spartanburg",
"state": "SC",
"postal_code": "293033077",
"country_code": "US",
"telephone_number": "864-560-6193",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAYLESS",
"first_name": "JAKE",
"middle_name": "HAMILTON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL40693",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NC",
"license": "2023-03317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.