Individual provider Active NPI

John Charles Bailey, M.D., MSPH

  • Public Health & General Preventive Medicine Physician
  • North Logan, UT
National Provider Identifier
1265733984
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
155578-1205 Issued in UT
Practice address
1330 E 2100 N
North Logan, UT 84341-2038
Phone
(435) 752-3097
NPI assigned
Nov 11, 2010
Last updated
Nov 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 155578-1205 UT Primary
Public Health & General Preventive Medicine Physician 2083P0901X 1555781205 UT

Addresses

Primary practice location

1330 E 2100 N
North Logan, UT 84341-2038

Mailing address

1330 E 2100 N
North Logan, UT 84341-2038
Phone (435) 752-3097

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
155578-1205UTMDPublic Health & General Preventive Medicine Physician
1555781205UTMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1265733984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 E 2100 N",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843412038",
            "telephone_number": "435-752-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E 2100 N",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843412038",
            "telephone_number": "435-752-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D., MSPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "UT",
            "license": "155578-1205",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "UT",
            "license": "1555781205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.