Individual provider Active NPI

John Riance Bailey III

  • Occupational Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1558848549
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
License
SP018643 Issued in PA
Practice address
230 N Broad St
Philadelphia, PA 19102-1121
Phone
(215) 762-8525
NPI assigned
Jul 23, 2018
Last updated
Jul 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X SP018643 PA Primary

Addresses

Primary practice location

230 N Broad St
Philadelphia, PA 19102-1121

Mailing address

230 N Broad St
Philadelphia, PA 19102-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105000511 NJ Practitioner - Nurse Practitioner 7315317542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

510 Heron Dr
Suite 108
Swedesboro, NJ 08085-1767
Phone (856) 467-8550

595 Division St
Elizabeth, NJ 07201-2038
Phone (908) 289-5646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of New Jersey PA CurrentSince Dec 12, 2022 Accepting new patients
American Current Care of New Jersey, P.a. Single Specialty Current Accepting new patients
American Current Care of New Jersey PA Single Specialty CurrentSince Dec 12, 2022 Accepting new patients

Locations

595 Division St
Elizabeth, NJ 07201
Phone (908) 289-5646

817 E Gate Dr
#102
Mount Laurel, NJ 08054
Phone (856) 778-1090

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1558848549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JOHN",
        "middle_name": "RIANCE",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "PA",
            "license": "SP018643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.