Individual provider Active NPI

Bailey Mackynzie Lenon, CST, CSFA

  • Surgical Assistant
  • Meridian, ID
National Provider Identifier
1417808791
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
209885 Issued in ID
Practice address
520 S Eagle Rd
Meridian, ID 83642-6351
Phone
(208) 706-5000
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 209885 ID Primary

Addresses

Primary practice location

520 S Eagle Rd
Meridian, ID 83642-6351

Mailing address

2112 W Anatole St
Meridian, ID 83646-3297
Phone (208) 954-9792

Other identifiers 1

IdentifierTypeStateIssuer
209885OtherIDNBSTSA

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
209885IDMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1417808791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 W ANATOLE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836463297",
            "telephone_number": "208-954-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-706-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENON",
        "first_name": "BAILEY",
        "middle_name": "MACKYNZIE",
        "credential": "CST, CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "ID",
            "license": "209885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBSTSA",
            "identifier": "209885",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.