Individual provider Active NPI

Michael Benjamin Bailey

  • Personal Care Attendant
  • Parma Heights, OH
National Provider Identifier
1205081957
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
2773280 Issued in OH
Practice address
10431 N Church Dr Apt 111
Parma Heights, OH 44130-8602
Phone
(440) 523-1517
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 2773280 OH Primary

Addresses

Primary practice location

10431 N Church Dr Apt 111
Parma Heights, OH 44130-8602

Mailing address

10431 N Church Dr Apt 111
Parma Heights, OH 44130-8602
Phone (440) 523-1517

Other identifiers 1

IdentifierTypeStateIssuer
2773280MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
2773280OHMDPersonal Care Attendant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1205081957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10431 N CHURCH DR APT 111",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441308602",
            "telephone_number": "440-523-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 N CHURCH DR APT 111",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441308602",
            "telephone_number": "440-523-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "MICHAEL",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "OH",
            "license": "2773280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773280",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.