Active NPI
John Allen Bailey
- Social Worker
- Brooklyn, NY
National Provider Identifier
1649921040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 112663-01
- Practice address
- 1118 Bedford Ave
Brooklyn, NY 11216-5578 - Phone
- (347) 566-5629
- NPI assigned
- Jan 17, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 112663-01 | NY | Primary |
Addresses
Primary practice location
1118 Bedford Ave
Brooklyn, NY 11216-5578
Mailing address
9811 23Rd Ave
East Elmhurst, NY 11369-1301
Phone (512) 954-8114
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112663-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642377600000",
"number": "1649921040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9811 23RD AVE",
"city": "EAST ELMHURST",
"state": "NY",
"postal_code": "113691301",
"telephone_number": "512-954-8114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 BEDFORD AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112165578",
"telephone_number": "347-566-5629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "JOHN",
"middle_name": "ALLEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-17",
"last_updated": "2022-01-17",
"certification_date": "2022-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "112663-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.