Individual provider Active NPI

Jeffrey Allen Bailey, ATC, NCTM

  • Specialist
  • Ashburn, VA
National Provider Identifier
1376780528
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0126001289 Issued in VA
Practice address
22525 Belmont Ridge Rd
Ashburn, VA 20148-6925
Phone
(703) 957-4408
NPI assigned
Jan 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0126001289 VA Primary

Addresses

Primary practice location

22525 Belmont Ridge Rd
Ashburn, VA 20148-6925

Mailing address

5132 Dumfries Rd
Warrenton, VA 20187-8925
Phone (540) 270-8175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0126001289VAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1376780528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 DUMFRIES RD",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201878925",
            "telephone_number": "540-270-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22525 BELMONT RIDGE RD",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201486925",
            "telephone_number": "703-957-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "credential": "ATC, NCTM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-09",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0126001289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.