Individual provider Active NPI

Nicole Anne Bailey, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1336417161
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4374 Issued in NC
Practice address
4829 Convoy St
San Diego, CA 92111-1610
Phone
(858) 279-7223
Fax
(858) 279-5343
NPI assigned
Dec 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4374 NC Primary
Chiropractor 111N00000X 32146 CA

Addresses

Primary practice location

4829 Convoy St
San Diego, CA 92111-1610

Mailing address

265 Racine Dr
St 100
Wilmington, NC 28403-8770
Phone (910) 798-5560

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140329000036 NC Practitioner - Chiropractic 0749411098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spinalcare of Wilmington, PLLCGroup PAC ID 6103918503, 2 clinicians

Practice addresses (Care Compare)

265 Racine Dr
Suite 100
Wilmington, NC 28403-8770
Phone (910) 798-5560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32146CAMDClinical Social Worker
4374NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Well Within Chiropractic PLLC Chiropractor CurrentSince Aug 15, 2015 Accepting new patients

Locations

265 Racine Dr
#100
Wilmington, NC 28403
Phone (910) 515-4525

Organizations & group practices 2

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": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1336417161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 RACINE DR",
            "address_2": "ST 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038770",
            "telephone_number": "910-798-5560",
            "fax_number": "910-798-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 CONVOY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111610",
            "telephone_number": "858-279-7223",
            "fax_number": "858-279-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4374",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.