Individual provider Active NPI

Aja Baillie, FNP-C

  • Family Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1609751403
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
281349 Issued in AZ
Practice address
5236 N Valle Dorado
Kingman, AZ 86409-1689
Phone
(928) 727-0106
NPI assigned
Aug 11, 2025
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 281349 AZ Primary

Addresses

Primary practice location

5236 N Valle Dorado
Kingman, AZ 86409-1689

Mailing address

5236 N Valle Dorado
Kingman, AZ 86409-1689
Phone (928) 727-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260616002947 AZ Practitioner - Nurse Practitioner 8527530039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Desert Dermatology and Surgery PCGroup PAC ID 6305732512, 11 clinicians

Practice addresses (Care Compare)

1700 Sycamore Ave
Kingman, AZ 86409-0927
Phone (928) 692-8885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
281349AZMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1609751403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5236 N VALLE DORADO",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864091689",
            "telephone_number": "928-727-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 N VALLE DORADO",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864091689",
            "telephone_number": "928-727-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLIE",
        "first_name": "AJA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "281349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.