Active NPI
Stefan Lee Bailey, ATC/LAT
- Athletic Trainer
- Gilbert, AZ
National Provider Identifier
1194482448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1675 E Melrose St Ste 101-103
Gilbert, AZ 85297-1001 - Phone
- (602) 648-5444
- Fax
- (602) 772-3801
- NPI assigned
- Nov 22, 2021
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1675 E Melrose St Ste 101-103
Gilbert, AZ 85297-1001
Mailing address
PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1194482448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80217",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850600217",
"telephone_number": "602-385-2115",
"fax_number": "480-418-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 E MELROSE ST STE 101-103",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852971001",
"telephone_number": "602-648-5444",
"fax_number": "602-772-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "STEFAN",
"middle_name": "LEE",
"credential": "ATC/LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-22",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.