Kelley Jo Bajillan, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

182481 Issued in NC

Practice address

5826 Samet Dr
High Point, NC 27265-3660

Phone

(336) 878-6540

Fax

(336) 878-6541

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Wright State University Boonshoft School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRX High Point PLLCGroup PAC ID 7113061730, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• DRX High Point, PLLC

  dba American Family Care

  • Multi-Specialty Clinic/Center
  • High Point, NC
  • NPI 1669701306
  Medicare reassignment Care Compare group NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• Regional Physicians LLC

  dba UNC Regional Physicians Carolina Cardiology

  • Cardiovascular Disease Physician
  • High Point, NC
  • NPI 1174981823
  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1437445962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "STE. 207C",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-883-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 SAMET DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272653660",
            "telephone_number": "336-878-6540",
            "fax_number": "336-878-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJILLAN",
        "first_name": "KELLEY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "182481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437445962",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• L'Tanya Joy Bailey, DDS, MS, PLLC
• Robert Christopher Bailey, DC
• Abby Allison Bailiff, NP
• Tamika N Bain
• Hendren Akram Bajillan, MD
• Haden Andrew Baker, PA
• Shauna Nicole Baker
• Baker's Counseling and Mentoring Center, Inc
• Ashley Balamucki
• Shriman Narayan Balasubramanian, DO

• Nurse Practitioner in High Point, NC
• Providers in High Point, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.