Active NPI
William Jeremy Bails, MSPT, DPT
- Specialist
- Salisbury, MD
National Provider Identifier
1528079704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 20434
- Practice address
- 1502 Pemberton Dr
Suite C
Salisbury, MD 21801 - Phone
- (410) 749-5050
- Fax
- (410) 749-5057
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 20434 | MD | Primary |
Addresses
Primary practice location
1502 Pemberton Dr
Suite C
Salisbury, MD 21801
Mailing address
1502 Pemberton Dr
Suite C
Salisbury, MD 21801
Phone (410) 749-5050
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F1060004 | Other | MD | BCBS FEDERAL NUMBER |
| LV43 | Other | MD | BCBS MD NUMBER |
| 362636 | Other | MD | MAMSI NUMBER |
| 143839ZCMG | Other | MD | MEDICARE GROUP MEMBER PROVIDER NUMBER |
| 612956020004 | Other | MD | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090206000567 | MD | Practitioner - Physical Therapist in Private Practice | 6305756032 |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6508 Deer Pointe Dr
Salisbury, MD 21804-1669
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20434 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland Sportscare & Rehabilitation of Salisbury, LLC | 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.
-
- Physical Therapist
- Salisbury, MD
- NPI 1205992971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1528079704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 PEMBERTON DR",
"address_2": "SUITE C",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21801",
"telephone_number": "410-749-5050",
"fax_number": "410-749-5057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 PEMBERTON DR",
"address_2": "SUITE C",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21801",
"telephone_number": "410-749-5050",
"fax_number": "410-749-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILS",
"first_name": "WILLIAM",
"middle_name": "JEREMY",
"name_prefix": "Mr.",
"credential": "MSPT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "20434",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FEDERAL NUMBER",
"identifier": "F1060004",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MD NUMBER",
"identifier": "LV43",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI NUMBER",
"identifier": "362636",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP MEMBER PROVIDER NUMBER",
"identifier": "143839ZCMG",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "612956020004",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.