Individual provider Active NPI

Marilyn Jennie Ann Bailey, FNP-C

  • Family Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1144063983
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
108131 Issued in WV
Practice address
122 12TH St
Princeton, WV 24740-2312
Phone
(304) 487-7274
NPI assigned
Jun 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 108131 WV Primary

Addresses

Primary practice location

122 12TH St
Princeton, WV 24740-2312

Mailing address

254 Kensington CT
Princeton, WV 24740-4260
Phone (304) 320-6267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240904002759 WV Practitioner - Nurse Practitioner 8729528864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Community Hospital Assn. Inc.Group PAC ID 3678482221, 174 clinicians

Practice addresses (Care Compare)

122 12TH St
Princeton, WV 24740-2312
Phone (304) 487-7936

Hospital & facility affiliations

  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn., Inc CurrentSince Aug 1, 2024 Accepting new patients
Princeton Community Hospital Assn Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

122 12th St
Princeton, WV 24740
Phone (304) 487-7061

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.

Hospital & facility affiliations 1

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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1144063983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 KENSINGTON CT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247404260",
            "telephone_number": "304-320-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 12TH ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402312",
            "telephone_number": "304-487-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "MARILYN JENNIE",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "108131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.