Shannon Theresa Bailey, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ14891300 Issued in NJ

Practice address

562 NJ - 23
Pompton Plains, NJ 07444

Phone

(973) 616-5437

NPI assigned

Aug 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baby Doc Inc

  dba Night Watch Pediatric Urgent Care

  • Urgent Care Clinic/Center
  • Manassas, VA
  • NPI 1174004774
  Medicare reassignment NPD
• Falls Church Pediatrics

  dba Kids Watch Pediatrics & Urgent Care

  • Primary Care Clinic/Center
  • Falls Church, VA
  • NPI 1588481576
  NPD (past)

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1285301499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 MACOPIN RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074801509",
            "telephone_number": "707-479-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 NJ - 23",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "07444",
            "telephone_number": "973-616-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHANNON",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024182216",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14891300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Assistingseniors Nj001 (Assisting Seniors at Home)
• Rustica Atienza, APN
• Ifomachukwu N Azih, M.D.
• Michelle C Azu, MD
• Klil Babin
• Ebube A. Bakosi, M.D.
• Pradeep Balasubramaniam, M.D.,
• Yaseen Baseer
• James Batayiannis II
• Todd Brian Bauer, PT

• Family Nurse Practitioner in Pompton Plains, NJ
• Providers in Pompton Plains, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.