Individual provider Active NPI

Beatrice Lynette Bailey, NP-C

  • Licensed Practical Nurse
  • San Bernardino, CA
National Provider Identifier
1750638037
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
F0712247 Issued in MS
Practice address
249 E Highland Ave
San Bernardino, CA 92404-3707
Phone
(909) 881-1683
Fax
(909) 881-4215
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X F0712247 MS Primary

Addresses

Primary practice location

249 E Highland Ave
San Bernardino, CA 92404-3707

Mailing address

25740 Mesa CT
San Bernardino, CA 92404-3074
Phone (909) 881-1683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130711000344 MS Practitioner - Nurse Practitioner 6204076474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0712247MSMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Apr 1, 2019 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Apr 1, 2019 Accepting new patients
On Time Healthcare & Consulting Inc Past Accepting new patients
Woman to Woman OB/GYN Medical Group, Inc PastSince Aug 1, 2005 Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

Interoperability endpoints

  • Direct secure messaging: beatrice.baileyrnp.p1@direct.plannedparenthoodla.nextgenshare.com

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1750638037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25740 MESA CT",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043074",
            "telephone_number": "909-881-1683",
            "fax_number": "909-881-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 E HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043707",
            "telephone_number": "909-881-1683",
            "fax_number": "909-881-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "BEATRICE",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "F0712247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.