NPIMap

Organization Active NPI

Kellie D. Bailey CCC-SLP PC

  • Speech-Language Pathologist
  • Warren, ME
National Provider Identifier
1699004176
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP655 Issued in ME
Legal business name
KELLIE D. BAILEY CCC-SLP PC
Practice address
3208 Camden Rd
Warren, ME 04864-4124
Phone
(207) 594-5076
Fax
(207) 594-7339
NPI assigned
Dec 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Mrs. Kellie D. Bailey, CCC-SLPNPI 1609091750
Title
Speech Pathologist
Phone
(207) 594-5076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP655 ME Primary

Addresses

Primary practice location

3208 Camden Rd
Warren, ME 04864-4124

Mailing address

3208 Camden Rd
Warren, ME 04864-4124
Phone (207) 594-5076

Other identifiers 3

IdentifierTypeStateIssuer
7313637OtherMEAETNA
207850000MedicaidME
035267OtherMEANTHEM BLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1699004176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 CAMDEN RD",
            "city": "WARREN",
            "state": "ME",
            "postal_code": "048644124",
            "telephone_number": "207-594-5076",
            "fax_number": "207-594-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 CAMDEN RD",
            "city": "WARREN",
            "state": "ME",
            "postal_code": "048644124",
            "telephone_number": "207-594-5076",
            "fax_number": "207-594-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLIE D. BAILEY CCC-SLP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "207-594-5076",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7313637",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207850000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "035267",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.