Elaine Burgwyn-Bailes, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2602 Issued in NC

Practice address

1502 W NC Highway 54
Suite 603
Durham, NC 27707-5571

Phone

(919) 419-3110

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Betsy Pedersen PHD PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Durham, NC
  • NPI 1346665882
  NPD (past)
• Nicole a. Engel, PH.D., P..C.

  • Clinical Psychologist
  • Durham, NC
  • NPI 1568583763
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679697288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 603",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-419-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "SUITE 603",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075571",
            "telephone_number": "919-419-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGWYN-BAILES",
        "first_name": "ELAINE",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "045C0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Burger, M.D.
• Meredith Burger
• Hannah Burgess
• Shelly Burgett
• Ciara Burgi
• Rollin Scofield Burhans Jr., MD
• Carol D. Burk, M.D.
• David Lawrence Burk, M.D.
• Burke Facilities II, LLC
• Caitlin Burke, M.S., CCC-SLP

• Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.