NPIMap

Individual provider Active NPI

Bailey Ann Lervick, DO

  • Emergency Medicine Physician
  • Bloomington, MN
National Provider Identifier
1184364101
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.017425 Issued in OH
Practice address
4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435
Phone
(952) 767-4574
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.017425 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

2213 Cherry St
Toledo, OH 43608-2603

Other practice location 1

2213 Cherry St
Toledo, OH 43608-2603
Phone (419) 251-4724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MN, ID3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20241231002357 OH Practitioner - Emergency Medicine 3678953148 Reassigns benefits to 1 organization
I20250613001402 MN Practitioner - Emergency Medicine 3678953148 Reassigns benefits to 1 organization
I20260518001123 ID Practitioner - Emergency Medicine 3678953148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association CurrentSince Aug 4, 2025 Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Emergency Physicians Professional Association Emergency Medicine Current Accepting new patients
Emergency Physicians Professional Association CurrentSince Aug 4, 2025 Accepting new patients

Locations

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

Organizations & group practices 5

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 8

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1184364101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKET PTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-767-4574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-4724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LERVICK",
        "first_name": "BAILEY",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.017425",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.