Individual provider Active NPI

Susan Melinda Bailey, FNP-BC

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1376137562
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN190692 Issued in GA
Practice address
3333 Jodeco Rd Ste D
McDonough, GA 30253-5319
Phone
(770) 474-1919
NPI assigned
Feb 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 RN190692 GA Primary

Addresses

Primary practice location

3333 Jodeco Rd Ste D
McDonough, GA 30253-5319

Mailing address

3333 Jodeco Rd Ste D
McDonough, GA 30253-5319
Phone (770) 474-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20221209002405 GA Practitioner - Nurse Practitioner 0749659944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Associates, LLC Current Accepting new patients
Family Medical and Urgent Care Clinic of McDonough, LLC CurrentSince Jul 23, 2022 Accepting new patients
Donna M. Haney M.D., P.C. PastSince Jul 23, 2022 Accepting new patients

Locations

1631 Highway 20 W
McDonough, GA 30253
Phone 7702882822 ext. 135

230 Plaza Dr
Zebulon, GA 30295
Phone (404) 569-1310

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJFBD

Organizations & group practices 3

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": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1376137562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 JODECO RD STE D",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535319",
            "telephone_number": "770-474-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 JODECO RD STE D",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535319",
            "telephone_number": "770-474-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SUSAN",
        "middle_name": "MELINDA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN190692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.