Active NPI
Keith Alan Bailey, RPH
- Pharmacist
- Radcliff, KY
National Provider Identifier
1174892384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 011467
- Practice address
- 635 S Dixie Blvd
Radcliff, KY 40160-1219 - Phone
- (270) 352-0880
- NPI assigned
- Dec 16, 2011
- Last updated
- Dec 16, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011467 | KY | Primary |
Addresses
Primary practice location
635 S Dixie Blvd
Radcliff, KY 40160-1219
Mailing address
440 Coleman Rd
Vine Grove, KY 40175-6139
Phone (270) 828-4446
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011467 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323993600000",
"number": "1174892384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 COLEMAN RD",
"city": "VINE GROVE",
"state": "KY",
"postal_code": "401756139",
"telephone_number": "270-828-4446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 S DIXIE BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401601219",
"telephone_number": "270-352-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "KEITH",
"middle_name": "ALAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-16",
"last_updated": "2011-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "011467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Radcliff, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.