Nancy S Bayly, O.D.
Individual provider Active NPI Optometrist · Rensselaer, IN
NPI 1194701060 · NPPES record last updated Aug 2, 2010
Key facts
- NPI
- 1194701060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 18002094A (IN)
- Practice address
- 212 S Van Rensselaer St
Rensselaer, IN 47978-2817 - Phone
- (219) 866-5661
- Fax
- (219) 866-8705
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002094A | IN | Yes |
Addresses
Primary practice location
212 S Van Rensselaer St
Rensselaer, IN 47978-2817
Mailing address
PO Box 260
Rensselaer, IN 47978-0260
Phone (219) 866-5661
Other providers in Rensselaer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.