Derrick Bailey

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11003419 Issued in FL

Practice address

36 Medical Group
Andersen AFB, GU 96543-4010

Phone

(671) 366-3231

NPI assigned

Sep 11, 2016

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1473552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1669929386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "36 MEDICAL GROUP",
            "address_2": "UNIT 14010 ANDERSEN AFB",
            "city": "APO",
            "state": "AP",
            "postal_code": "965434010",
            "telephone_number": "671-366-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MEDICAL GROUP",
            "city": "ANDERSEN AFB",
            "state": "GU",
            "postal_code": "965434010",
            "telephone_number": "671-366-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "DERRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9369759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andersen Phcy
• John Garcia, IDMT
• Benjamin Huyck
• Imee Sarmiento Kiser, IDMT
• Scott Christopher Martin, O.D.
• Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT

• Family Nurse Practitioner in Andersen AFB, GU
• Providers in Andersen AFB, GU by specialty
• Family Nurse Practitioner in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.