Active NPI
Terrell Wayne Bailey, DDS
- Dentist
- Greenwood, AR
National Provider Identifier
1467512079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2864
- Practice address
- 520 Hamilton Lane
Greenwood, AR 72936 - Phone
- (479) 996-6555
- Fax
- (479) 996-6536
- NPI assigned
- Dec 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2864 | AR | Primary |
Addresses
Primary practice location
520 Hamilton Lane
Greenwood, AR 72936
Mailing address
701 C 7TH Street
Mena, AR 71953
Phone (479) 394-5666
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 884517 | Other | PA | UNITED CONCORDIA |
| 58213 | Other | AR | BCBS FEDERAL |
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 |
|---|---|---|---|
| 2864 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dentistry | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Mena, AR
- NPI 1710101548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467512079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 C 7TH STREET",
"city": "MENA",
"state": "AR",
"postal_code": "71953",
"telephone_number": "479-394-5666",
"fax_number": "479-996-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 HAMILTON LANE",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "72936",
"telephone_number": "479-996-6555",
"fax_number": "479-996-6536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "TERRELL",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "2864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "884517",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FEDERAL",
"identifier": "58213",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.