Individual provider Active NPI

Baili Rose Bailey, PA-C

  • Physician Assistant
  • Georgetown, KY
National Provider Identifier
1760200414
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC062 Issued in KY
Practice address
210 Bevins LN Ste C
Georgetown, KY 40324-6127
Phone
(502) 868-0622
Fax
(502) 868-9097
NPI assigned
Oct 1, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC062 KY Primary

Addresses

Primary practice location

210 Bevins LN Ste C
Georgetown, KY 40324-6127

Mailing address

210 Bevins LN Ste C
Georgetown, KY 40324-6127
Phone (502) 868-0622

Other names 1

  • Baili Rose Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20241114002925 KY Practitioner - Physician Assistant 0143754028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

210 Bevins LN
Georgetown, KY 40324-6127

210 Bevins LN C
Georgetown, KY 40324-6127
Phone (502) 868-0622

96 Future Dr
Corbin, KY 40701-8988
Phone (606) 528-0305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TC062KYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

96 Future Dr
Corbin, KY 40701

210 Bevins Ln
Ste C
Georgetown, KY 40324
Phone (502) 868-0622

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1760200414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BEVINS LN STE C",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403246127",
            "telephone_number": "502-868-0622",
            "fax_number": "502-868-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEVINS LN STE C",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403246127",
            "telephone_number": "502-868-0622",
            "fax_number": "502-868-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "BAILI",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAILI",
            "last_name": "SMITH",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.