Individual provider Active NPI

Leah Bailiff, NP

  • Neonatal Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1629112990
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
11582 Issued in TN
Practice address
1930 Alcoa Hwy Ste 145
Knoxville, TN 37920
Phone
(865) 582-3123
Fax
(865) 305-5857
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 11582 TN Primary

Addresses

Primary practice location

1930 Alcoa Hwy Ste 145
Knoxville, TN 37920

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6039

Other practice location 1

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6671

Other identifiers 1

IdentifierTypeStateIssuer
APN11582OtherTNSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190701002490 TN Practitioner - Nurse Practitioner 2365776903 Reassigns benefits to 1 organization
I20221116001911 NC Practitioner - Nurse Practitioner 2365776903 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11582TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC Nurse Practitioner CurrentSince May 22, 2019 Accepting new patients
Mission Health Community Multispecialty Providers, LLC CurrentSince Aug 4, 2022 Accepting new patients
Mission Health Community Multispecialty Providers, LLC Current Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Aug 4, 2022 Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

Interoperability endpoints

  • Direct secure messaging: leahbailiff@hmgpath.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1629112990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ALCOA HWY STE 145",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37920",
            "telephone_number": "865-582-3123",
            "fax_number": "865-305-5857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6671",
            "fax_number": "423-431-3681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILIFF",
        "first_name": "LEAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TN",
            "license": "11582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APN11582",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.