Individual provider Active NPI

Nancy S Bayly, O.D.

  • Optometrist
  • Rensselaer, IN
National Provider Identifier
1194701060
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002094A Issued in 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
Last updated
Aug 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002094A IN Primary

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

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)
Enrolled

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1194701060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479780260",
            "telephone_number": "219-866-5661",
            "fax_number": "219-866-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S VAN RENSSELAER ST",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479782817",
            "telephone_number": "219-866-5661",
            "fax_number": "219-866-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLY",
        "first_name": "NANCY",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002094A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.