Organization Active NPI

Bailey Psychology Group P a

  • Clinical Psychologist
  • Safety Harbor, FL
National Provider Identifier
1487054904
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BAILEY PSYCHOLOGY GROUP P A
Practice address
108 4TH Ave S
Safety Harbor, FL 34695-4020
Phone
(480) 720-7411
Fax
(877) 454-6994
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Melissa Bailey, MD
Title
Medical Director
Phone
(813) 720-7411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

108 4TH Ave S
Safety Harbor, FL 34695-4020

Mailing address

108 4TH Ave S
Safety Harbor, FL 34695-4020
Phone (813) 720-7411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150206001773 CA Part B Supplier - Clinic/Group Practice 1951626316 Receives reassigned benefits from 2 practitioners
Practice locations: Long Beach, CA
O20170920001949 FL Part B Supplier - Clinic/Group Practice 1951626316 Receives reassigned benefits from 3 practitioners
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

1536 W 25th St
#108
San Pedro, CA 90732
Phone (310) 819-3862

108 4th Ave S
Ste B
Safety Harbor, FL 34695
Phone (813) 720-7411

108 4th Ave S
Safety Harbor, FL 34695
Phone (727) 793-9177

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1487054904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 4TH AVE S",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954020",
            "telephone_number": "813-720-7411",
            "fax_number": "877-454-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 4TH AVE S",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954020",
            "telephone_number": "480-720-7411",
            "fax_number": "877-454-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAILEY PSYCHOLOGY GROUP P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-720-7411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.