Individual provider Active NPI

Shelby Kint Bailey, M.D.

  • Surgery Physician
  • Florence, AL
National Provider Identifier
1801850995
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00011545 Issued in AL
Practice address
501 E Dr Hicks Blvd Ste a
Florence, AL 35630-5742
Phone
(256) 383-0423
Fax
(256) 383-0922
NPI assigned
Apr 14, 2006
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 00011545 AL Primary

Addresses

Primary practice location

501 E Dr Hicks Blvd Ste a
Florence, AL 35630-5742

Mailing address

8075 Madison Blvd
Ste 112
Madison, AL 35758-2042
Phone (256) 772-6018

Other identifiers 1

IdentifierTypeStateIssuer
051556654MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430001056 AL Practitioner - General Practice 3274521174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00011545ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoals Surgical Group LLC Surgery CurrentSince Aug 22, 2005 Accepting new patients
Vein Clinics of Hawaii LLC PastSince Feb 25, 2013 Accepting new patients
Surgical Associates of the Shoals, PC Past Accepting new patients
Desselle Surgical Clinic, LLC Surgery Past Accepting new patients

Locations

501 E Dr Hicks Blvd
Ste A
Florence, AL 35630
Phone (256) 383-0423

8075 Madison Blvd
Ste 112
Madison, AL 35758
Phone (256) 772-6018

203 Avalon Ave
Ste 100
Muscle Shoals, AL 35661
Phone (256) 314-6947

1100 S Jackson Hwy
Ste 101
Sheffield, AL 35660
Phone (256) 381-5955

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, 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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1801850995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8075 MADISON BLVD",
            "address_2": "STE 112",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582042",
            "telephone_number": "256-772-6018",
            "fax_number": "256-772-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E DR HICKS BLVD STE A",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305742",
            "telephone_number": "256-383-0423",
            "fax_number": "256-383-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHELBY",
        "middle_name": "KINT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "00011545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556654",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.