Individual provider Active NPI

Mary Elaine Bailey, NP

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1326329566
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN181781 Issued in GA
Practice address
2210 State Road 580
Clearwater, FL 33763-1126
Phone
(727) 615-3133
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN181781 GA Primary

Addresses

Primary practice location

2210 State Road 580
Clearwater, FL 33763-1126

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (615) 315-5257

Other identifiers 1

IdentifierTypeStateIssuer
RN181781OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240118001415 FL Practitioner - Nurse Practitioner 4587835384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Medical of Florida LLCGroup PAC ID 5597127456, 15 clinicians

Practice addresses (Care Compare)

2210 Main St
Dunedin, FL 34698
Phone (727) 615-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN181781GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Medical of Florida, LLC CurrentSince Dec 11, 2023 Accepting new patients

Locations

2210 State Road 580
Clearwater, FL 33763
Phone (727) 615-3133

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1326329566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "615-315-5257",
            "fax_number": "615-692-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 STATE ROAD 580",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631126",
            "telephone_number": "727-615-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "MARY",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN181781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN181781",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.