Ronald Wesley Bailey, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

66563 Issued in GA

Practice address

Mountain Home Afb Medical Group
90 Hope Drive, Building 6000
Mountain Home Afb, ID 83648

Phone

(208) 828-7815

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1316005143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 MICHAELS CRK",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094042",
            "telephone_number": "706-868-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOUNTAIN HOME AFB MEDICAL GROUP",
            "address_2": "90 HOPE DRIVE, BUILDING 6000",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "83648",
            "telephone_number": "208-828-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "RONALD",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "66563",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2000-00713",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "66563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 366TH Medgrp-Mountain Home
• 366TH Medgrp-Mountain Home
• 366TH Medical Group SGSL
• Andrew Alton
• Nathan Lee Anderson, O.D.
• Becky M Bautch, AGACNP-BC
• Kenneth Becker, ATC
• Michael Bocek, PHARMD
• Paul Michael Bodes, PHARMD
• Shannon Lee Brantley, PHARMD

• Diagnostic Radiology Physician in Mountain Home Afb, ID
• Providers in Mountain Home Afb, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.