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Individual provider Active NPI

Maureen Bailey-Nutting, PA

  • Medical Physician Assistant
  • Greenville, SC
National Provider Identifier
1699775882
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1097 Issued in SC
Practice address
1028 N Church St
Greenville, SC 29601-1639
Phone
(864) 271-1464
Fax
(864) 467-9119
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1097 SC Primary

Addresses

Primary practice location

1028 N Church St
Greenville, SC 29601-1639

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 271-1464

Other identifiers 3

IdentifierTypeStateIssuer
1049253OtherSCNCCPA
1699775882OtherNPI NUMBER
1097OtherSCSTATE MEDICAL LICENSE NUMBER

Other names 1

  • Maureen Bailey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000759 SC Practitioner - Physician Assistant 1153411954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Physician Services IncGroup PAC ID 6608826821, 106 clinicians

Practice addresses (Care Compare)

1028 N Church St
Greenville, SC 29601-1639
Phone (864) 271-1464

1200 Brookfield Blvd
Suite 400B
Greenville, SC 29607-6583
Phone (864) 605-3721

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1097SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc CurrentSince Apr 30, 2012 Accepting new patients
St Francis Physician Services Inc CurrentSince Apr 30, 2012 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients
Carolina Medical Center Past Accepting new patients

Locations

1028 N Church St
Greenville, SC 29601
Phone (864) 271-1464

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

Organizations & group practices 4

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1699775882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-271-1464",
            "fax_number": "864-467-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 N CHURCH ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296011639",
            "telephone_number": "864-271-1464",
            "fax_number": "864-467-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY-NUTTING",
        "first_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1049253",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1699775882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE NUMBER",
            "identifier": "1097",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "BAILEY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.