Individual provider Active NPI

Rashaun Bailey, ATC, NREMT

  • Athletic Trainer
  • Mentor, OH
National Provider Identifier
1386099349
Registry record updated Nov 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0797 Issued in MS
Practice address
8655 Market St
Mentor, OH 44060-4170
Phone
(216) 647-8771
NPI assigned
Apr 27, 2016
Last updated
Nov 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 183551 OH
Athletic Trainer 2255A2300X AT0797 MS Primary

Addresses

Primary practice location

8655 Market St
Mentor, OH 44060-4170

Mailing address

14240 Ryan Dr
Walton Hills, OH 44146-4181
Phone (216) 647-8771

Other practice location 1

1400 John R Lynch St
Jackson, MS 39217-0002
Phone (601) 979-7032

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
183551OHMDBasic Emergency Medical Technician
AT0797MSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573344000000",
    "number": "1386099349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14240 RYAN DR",
            "city": "WALTON HILLS",
            "state": "OH",
            "postal_code": "441464181",
            "telephone_number": "216-647-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 MARKET ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604170",
            "telephone_number": "216-647-8771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 John R Lynch St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392170002",
            "country_code": "US",
            "telephone_number": "601-979-7032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "RASHAUN",
        "credential": "ATC, NREMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2019-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "OH",
            "license": "183551",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2019; 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.