Lita C Bailly, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP081328 Issued in ME

Practice address

1217 Bonita St
Grants, NM 87020-2103

Phone

(505) 287-2950

Fax

(505) 287-2403

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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.

• Newport Family Practice PA

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  • NPI 1760450910
  NPD (past)
• Pawhuska IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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• Pawnee IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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  • NPI 1124178017
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• Sunbury Primary Care, P.a.

  • Family Medicine Physician
  • Bangor, ME
  • NPI 1437242294

  Family

  NPD (past)
• Sunbury Primary Care, P.a.

  • Family Medicine Physician
  • Bangor, ME
  • NPI 1508939398
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

• Ms. Lita C Bailly Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 27, 2011.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1306856166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 BONITA ST",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202103",
            "telephone_number": "505-287-2950",
            "fax_number": "505-287-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 BONITA ST",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202103",
            "telephone_number": "505-287-2950",
            "fax_number": "505-287-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLY",
        "first_name": "LITA",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R029543",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP081328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335260099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LITA",
            "last_name": "BAILLY",
            "middle_name": "C",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kiran Aryal
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• Atomicare LLC
• H N Augenstein, MD
• Amanda Jo Baca
• Alicia Renee Balok, RN, IBCLC
• Jeremy Michael Barnes
• Noelle Baroody, PA-C, DOM
• Tamara Bennett, RN
• Shanelle Amber Benton, CSW / PSR INSTRUCTOR

• All providers in Grants, NM
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.