Kimberly Faun Bailey, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

268524 Issued in AZ

Practice address

448 N Hwy 89 Ste H
Chino Valley, AZ 86323-5957

Phone

(928) 636-3269

NPI assigned

Jan 4, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 26, 2023 through May 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kimberly.bailey@402065131372548.direct.elationemr.com

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1376204271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 N HWY 89 STE H",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235957",
            "telephone_number": "928-636-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 N HWY 89 STE H",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235957",
            "telephone_number": "928-636-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KIMBERLY",
        "middle_name": "FAUN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "268524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arizona Handicab LLC
• Megan Ashkanian, LPC
• Jason Layne Austin, DC
• Augustine Fella Aworuwa, BS PHARM
• Az Express Ride LLC
• Gerald Baldwin, PA-C
• Pete Banchuin, MD
• Ellina Rose Bastian
• Erin Benson
• Theresa Loreen Boen, ED.S.

• Family Nurse Practitioner in Chino Valley, AZ
• Providers in Chino Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.