Individual provider Active NPI

Dylan Priddy Bailey

  • Physician Assistant
  • Williamsburg, VA
National Provider Identifier
1669900643
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5500 Issued in TN
Practice address
5424 Discovery Park Blvd
Building B, Suite 104
Williamsburg, VA 23188
Phone
(757) 206-1113
NPI assigned
Jun 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA20181 TX
Physician Assistant 363A00000X 5500 TN Primary

Addresses

Primary practice location

5424 Discovery Park Blvd
Building B, Suite 104
Williamsburg, VA 23188

Mailing address

5424 Discovery Park Blvd
Building B, Suite 104
Williamsburg, VA 23188
Phone (757) 206-1113

Other practice location 1

2240 Gulf Fwy S Ste 2.110
League City, TX 77573-5143
Phone (832) 505-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AL, TN, VA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20170901000036 WA Practitioner - Physician Assistant 0143593707 Reassigns benefits to 2 organizations
I20221213002104 AL Practitioner - Physician Assistant 0143593707 Reassigns benefits to 1 organization
I20230424001529 TN Practitioner - Physician Assistant 0143593707 Reassigns benefits to 3 organizations
I20250210000818 VA Practitioner - Physician Assistant 0143593707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4125 Ironbound Rd
Suite 200
Williamsburg, VA 23188-2666
Phone (757) 345-2829

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 1, 2025 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

860 Omni Blvd
Ste 401
Newport News, VA 23606
Phone (757) 232-8764

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1669900643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BLVD",
            "address_2": "BUILDING B, SUITE 104",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-206-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BLVD",
            "address_2": "BUILDING B, SUITE 104",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-206-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2240 Gulf Fwy S Ste 2.110",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775735143",
            "country_code": "US",
            "telephone_number": "832-505-1600",
            "fax_number": "281-309-0147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "DYLAN",
        "middle_name": "PRIDDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA20181",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.