Individual provider Active NPI

Rebecca V Bailey, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1770919060
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
04511 Issued in NC
Practice address
1130 Situs CT Ste 190
Raleigh, NC 27606-3372
Phone
(919) 792-3940
NPI assigned
Sep 19, 2013
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 04511 NC
Physician Assistant 363A00000X 04511 NC Primary

Addresses

Primary practice location

1130 Situs CT Ste 190
Raleigh, NC 27606-3372

Mailing address

2511 Old Cornwallis Rd Ste 200
Durham, NC 27713-1869
Phone (919) 932-5700

Other practice location 1

2511 Old Cornwallis Rd Ste 200
Durham, NC 27713-1869
Phone (919) 932-5700 ext. 333

Other identifiers 1

IdentifierTypeStateIssuer
1113209OtherNCNCCPA ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20131122000098 NC Practitioner - Physician Assistant 5890921803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

4 Doctors Park
Suite H
Asheville, NC 28801-4523
Phone (828) 633-6070

4700 Falls of Neuse Rd
Suite 355
Raleigh, NC 27609-6275
Phone (919) 876-3130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04511NCMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1770919060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 OLD CORNWALLIS RD STE 200",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131869",
            "telephone_number": "919-932-5700",
            "fax_number": "919-933-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SITUS CT STE 190",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063372",
            "telephone_number": "919-792-3940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2511 Old Cornwallis Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277131869",
            "country_code": "US",
            "telephone_number": "919-932-5700 x333",
            "fax_number": "919-933-6881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "REBECCA",
        "middle_name": "V",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "04511",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "04511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA ID",
            "identifier": "1113209",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.