Individual provider Active NPI

Bailey Ross, LLMSW

  • Social Worker
  • Saint Clair Shores, MI
National Provider Identifier
1811606288
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851114998 Issued in MI
Practice address
19611 E 8 Mile Rd
Saint Clair Shores, MI 48080-1655
Phone
(586) 541-9550
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1447981477 NC
Social Worker 104100000X 6851114998 MI Primary

Addresses

Primary practice location

19611 E 8 Mile Rd
Saint Clair Shores, MI 48080-1655

Mailing address

3019 Trappers Cove TRL Apt 2B
Lansing, MI 48910-8509
Phone (616) 755-6209

Other practice location 1

812 E Jolly Rd Ste 210
Lansing, MI 48910-6821
Phone (517) 346-8275

Other practice location 2

756 Tyvola Rd Ste 116
Charlotte, NC 28217-3535
Phone (980) 265-1001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231107002127 MI Order and Referring Only - Clinical Social Worker 1951758374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851114998MIMDSocial Worker
1447981477NCMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1811606288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 TRAPPERS COVE TRL APT 2B",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108509",
            "telephone_number": "616-755-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19611 E 8 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801655",
            "telephone_number": "586-541-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 E Jolly Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489106821",
            "country_code": "US",
            "telephone_number": "517-346-8275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "756 Tyvola Rd Ste 116",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282173535",
            "country_code": "US",
            "telephone_number": "980-265-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "BAILEY",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "1447981477",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851114998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.