Active NPI
Kellie Bailey
- Registered Dietitian
- Joliet, IL
National Provider Identifier
1447699707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164002966
- Practice address
- 333 Madison St
Joliet, IL 60435-8200 - Phone
- (815) 725-7133
- NPI assigned
- Jun 20, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164002966 | IL | Primary |
Addresses
Primary practice location
333 Madison St
Joliet, IL 60435-8200
Mailing address
333 Madison St
Joliet, IL 60435-8200
Phone (815) 725-7133
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164002966 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1447699707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 MADISON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358200",
"telephone_number": "815-725-7133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 MADISON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358200",
"telephone_number": "815-725-7133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "KELLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-20",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164002966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.