Individual provider Active NPI

Dominique C Bailey, MD, FAAP

  • Pediatrics Physician
  • Easton, PA
National Provider Identifier
1801883384
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD040747L Issued in PA
Practice address
2401 Northampton St Ste 210
Easton, PA 18045-2764
Phone
(484) 591-7470
NPI assigned
Sep 30, 2005
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD76939 GA
Pediatrics Physician 208000000X MD040747L PA Primary

Addresses

Primary practice location

2401 Northampton St Ste 210
Easton, PA 18045-2764

Mailing address

165 Blue Ridge Overlook
Blue Ridge, GA 30513-4431
Phone (706) 946-5608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814003852 PA Practitioner - Pediatric Medicine 2466712625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD76939GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jul 24, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 24, 2023 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients

Locations

1611 Pond Rd
Ste 400
Allentown, PA 18104
Phone (484) 273-4836

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2401 Northampton St
Ste 210
Easton, PA 18045
Phone (484) 591-7470

101 W 7th St
Ste 2C
Pennsburg, PA 18073
Phone (215) 679-9321

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: dbailey812255@direct2.lvhn.org
  • Direct secure messaging: dominique.bailey@lbp.eclinicaldirectplus.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, 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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1801883384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-946-5608",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 NORTHAMPTON ST STE 210",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180452764",
            "telephone_number": "484-591-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "DOMINIQUE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD, FAAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "MD76939",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD040747L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.