Individual provider Active NPI

Daniel James Bailly, MD

  • Cardiovascular Disease Physician
  • Salem, OR
National Provider Identifier
1710988696
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD12677 Issued in OR
Practice address
885 Mission St SE
Salem, OR 97302-6222
Phone
(503) 585-5585
Fax
(503) 587-7823
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD12677 OR Primary

Addresses

Primary practice location

885 Mission St SE
Salem, OR 97302-6222

Mailing address

885 Mission St SE
Salem, OR 97302-6222
Phone (503) 585-5585

Other identifiers 1

IdentifierTypeStateIssuer
226811MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12677ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Cardiovascular Associates, PC Cardiovascular Disease PastSince Sep 1, 2002 Accepting new patients
Salem Health Past Accepting new patients
Salem Health West Valley Past Accepting new patients
Salem Health Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1710988696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026222",
            "telephone_number": "503-585-5585",
            "fax_number": "503-587-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026222",
            "telephone_number": "503-585-5585",
            "fax_number": "503-587-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLY",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD12677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226811",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.