NPIMap

Individual provider Active NPI

Robin Keith Bailey, PA-C, MD

  • Physician Assistant
  • Rockwell, NC
National Provider Identifier
1407875008
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2145 Issued in FL
Practice address
318 Trappers Ridge Dr
Rockwell, NC 28138-8573
Phone
(727) 433-2179
NPI assigned
Jul 18, 2006
Last updated
Jan 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2145 FL Primary
General Practice Physician 208D00000X 101393 NC

Addresses

Primary practice location

318 Trappers Ridge Dr
Rockwell, NC 28138-8573

Mailing address

318 Trappers Ridge Dr
Rockwell, NC 28138-8573
Phone (727) 433-2179

Other identifiers 1

IdentifierTypeStateIssuer
292305000MedicaidFL

Other names 1

  • Dr. R Keith Bailey Professional name

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)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
101393NCMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients
University Medical Service Association Inc Past Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients
Center for Dermatology and Skin Surgery Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1407875008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 TRAPPERS RIDGE DR",
            "city": "ROCKWELL",
            "state": "NC",
            "postal_code": "281388573",
            "telephone_number": "727-433-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 TRAPPERS RIDGE DR",
            "city": "ROCKWELL",
            "state": "NC",
            "postal_code": "281388573",
            "telephone_number": "727-433-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ROBIN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PA-C, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2145",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "101393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292305000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "BAILEY",
            "middle_name": "KEITH",
            "prefix": "DR.",
            "credential": "PA-C, MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rockwell, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.