Active NPI
Jordan Bailey
- Athletic Trainer
- Minden, LA
National Provider Identifier
1417596198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 320487
- Practice address
- 216 W Union St
Minden, LA 71055-3216 - Phone
- (318) 299-6334
- NPI assigned
- Dec 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 320487 | LA | Primary |
Addresses
Primary practice location
216 W Union St
Minden, LA 71055-3216
Mailing address
1203 Lewisville Rd
Minden, LA 71055-2146
Phone (440) 541-8491
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
| License | State | Type | Specialty |
|---|---|---|---|
| 320487 | LA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minden Physician Practices LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Minden, LA
- NPI 1497986764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1417596198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 LEWISVILLE RD",
"city": "MINDEN",
"state": "LA",
"postal_code": "710552146",
"telephone_number": "440-541-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W UNION ST",
"city": "MINDEN",
"state": "LA",
"postal_code": "710553216",
"telephone_number": "318-299-6334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "320487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minden, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.