Active NPI
Kelly Bailey
- Pediatrics Physician
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD.61142499
- Practice address
- 101 W 8TH Ave
Spokane, WA 99204-2307 - Phone
- (509) 474-3131
- NPI assigned
- Mar 30, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | 63489 | WI | |
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | MD61142499 | WA | |
| Pediatrics Physician | 208000000X | MD.61142499 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave
Spokane, WA 99204-2307
Mailing address
PO Box 383
Spokane, WA 99210-0383
Phone (800) 225-0953
Other practice location 1
8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-4575
Other practice location 2
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629311477 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190425001654 | WI | Practitioner - Emergency Medicine | 3577856103 | Reassigns benefits to 1 organization |
| I20210722003301 | WA | Practitioner - Emergency Medicine | 3577856103 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.61142499 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Multicare Health System | Pediatrics | Current | Accepting new patients |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Valley Children'S Medical Group | Pediatrics | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336
317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625
Interoperability endpoints
- kbailey608517@direct.multicare.org
Organizations & group practices 5
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.
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1629311477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 383",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992100383",
"telephone_number": "800-225-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-474-3131"
}
],
"practiceLocations": [
{
"address_1": "8701 W Watertown Plank Rd",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263548",
"country_code": "US",
"telephone_number": "414-955-4575",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9000 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532264874",
"country_code": "US",
"telephone_number": "414-266-2625",
"fax_number": "414-266-2635",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAILEY",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-30",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "WI",
"license": "63489",
"primary": false
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "WA",
"license": "MD61142499",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD.61142499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629311477",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.