Individual provider Active NPI

Kenny L Bailey II, RPH

  • Pharmacist
  • Kountze, TX
National Provider Identifier
1619574183
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24104 Issued in TX
Practice address
155 W Monroe St
Kountze, TX 77625-7613
Phone
(409) 246-2525
NPI assigned
Oct 7, 2020
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24104 TX Primary

Addresses

Primary practice location

155 W Monroe St
Kountze, TX 77625-7613

Mailing address

PO Box 321
Village Mills, TX 77663-0321
Phone (409) 550-4225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
24104TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brookshire Brothers Inc PastSince Oct 11, 2020 Accepting new patients
Brookshire Brothers Inc PastSince Oct 11, 2020 Accepting new patients

Organizations & group practices 2

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": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1619574183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321",
            "city": "VILLAGE MILLS",
            "state": "TX",
            "postal_code": "776630321",
            "telephone_number": "409-550-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W MONROE ST",
            "city": "KOUNTZE",
            "state": "TX",
            "postal_code": "776257613",
            "telephone_number": "409-246-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KENNY",
        "middle_name": "L",
        "name_suffix": "II",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "24104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kountze, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.