Active NPI
Courtney Mitchell Bailey, MD
- Anesthesiology Physician
- Park City, UT
National Provider Identifier
1619089141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 92-142320-1205
- Practice address
- 900 Round Valley
Park City Medical Center
Park City, UT 84060 - Phone
- (435) 658-7000
- Fax
- (801) 733-5618
- NPI assigned
- Aug 31, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 92-142320-1205 | UT | Primary |
Addresses
Primary practice location
900 Round Valley
Park City Medical Center
Park City, UT 84060
Mailing address
3340 North Center St
#800
Lehi, UT 84043-7406
Phone (801) 990-1910
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8597445 | Other | UT | WORKERS COMP |
| 870545614BA1 | Other | UT | EDUCATORS MUTUAL |
| 774803 | Medicaid | AZ | |
| 806156700 | Medicaid | ID | |
| 995 | Other | UT | HEALTHY U |
| 1502954 | Other | UT | UMWA |
| 117040600 | Medicaid | WY | |
| 38386 | Other | UT | PEHP |
| 107006128101 | Other | UT | IHC |
| 2090168 | Other | UT | UNITED HEALTHCARE |
| 261705 | Other | UT | DESERET MUTUAL |
| 002083089 | Medicaid | NV | |
| PRA02122 | Other | UT | MOLINA |
| QM0000075886 | Other | UT | ALTIUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92-142320-1205 | UT | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1619089141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 NORTH CENTER ST",
"address_2": "#800",
"city": "LEHI",
"state": "UT",
"postal_code": "840437406",
"telephone_number": "801-990-1910",
"fax_number": "801-990-1912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 ROUND VALLEY",
"address_2": "PARK CITY MEDICAL CENTER",
"city": "PARK CITY",
"state": "UT",
"postal_code": "84060",
"telephone_number": "435-658-7000",
"fax_number": "801-733-5618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "COURTNEY",
"middle_name": "MITCHELL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "92-142320-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "8597445",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870545614BA1",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "774803",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806156700",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "995",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1502954",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117040600",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "38386",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107006128101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2090168",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "261705",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002083089",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PRA02122",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000075886",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.