Organization Active NPI

Roger D. Bailey DC PLLC

  • Chiropractor
  • Pulaski, TN
National Provider Identifier
1154525863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
325 Issued in TN
Legal business name
ROGER D. BAILEY DC PLLC
Practice address
1119 E College St
Suite 4
Pulaski, TN 38478-4563
Phone
(931) 424-3331
Fax
(931) 363-9777
NPI assigned
Jun 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roger D. Bailey, D.C.
Title
Owner
Phone
(931) 424-3331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 325 TN Primary

Addresses

Primary practice location

1119 E College St
Suite 4
Pulaski, TN 38478-4563

Mailing address

1119 E College St
Suite 4
Pulaski, TN 38478-4563
Phone (931) 424-3331

Other identifiers 3

IdentifierTypeStateIssuer
4053304OtherTNBCBS
6143906OtherTNCIGNA HEALTHCARE
DF6318OtherTNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1119 E College St
Ste 4
Pulaski, TN 38478
Phone (931) 283-6629

1187 W College St
Ste 4
Pulaski, TN 38478
Phone (931) 424-3331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154525863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 E COLLEGE ST",
            "address_2": "SUITE 4",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784563",
            "telephone_number": "931-424-3331",
            "fax_number": "931-363-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 E COLLEGE ST",
            "address_2": "SUITE 4",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784563",
            "telephone_number": "931-424-3331",
            "fax_number": "931-363-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER D. BAILEY DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-424-3331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4053304",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "6143906",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF6318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.