NPIMap

Individual provider Active NPI

Gladys Bailon, M.D.

  • Family Medicine Physician
  • Soldotna, AK
National Provider Identifier
1467436071
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AA4445 Issued in AK
Practice address
161 N Binkley St
Suite 101
Soldotna, AK 99669-7521
Phone
(907) 260-7784
NPI assigned
Dec 6, 2005
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AA4445 AK Primary

Addresses

Primary practice location

161 N Binkley St
Suite 101
Soldotna, AK 99669-7521

Mailing address

PO Box 1249
Soldotna, AK 99669-1249
Phone (907) 260-7784

Other identifiers 1

IdentifierTypeStateIssuer
MD54821MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105001031 AK Practitioner - Family Practice 3375506736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

161 N Binkley St
Suite 101
Soldotna, AK 99669-7571
Phone (907) 260-7784

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AA4445AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Family Practice Clinic PC Family Medicine CurrentSince Jan 1, 2005 Accepting new patients

Locations

161 N Binkley St
Ste 101
Soldotna, AK 99669
Phone (907) 260-7784

206 W Rockwell Ave
Ste 101
Soldotna, AK 99669
Phone (907) 260-7784

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1467436071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1249",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996691249",
            "telephone_number": "907-260-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 N BINKLEY ST",
            "address_2": "SUITE 101",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-260-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILON",
        "first_name": "GLADYS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "AA4445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD54821",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.