NPIMap

Individual provider Active NPI

Leisa H Bailey, M.D.

  • Family Medicine Physician
  • Bonifay, FL
National Provider Identifier
1851314330
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0063592 Issued in FL
Practice address
101 E Wisconsin Ave
Bonifay, FL 32425-1809
Phone
(850) 547-2209
Fax
(850) 547-4521
NPI assigned
Jul 25, 2006
Last updated
May 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0063592 FL Primary

Addresses

Primary practice location

101 E Wisconsin Ave
Bonifay, FL 32425-1809

Mailing address

101 E Wisconsin Ave
Bonifay, FL 32425-1809
Phone (850) 547-2209

Other identifiers 1

IdentifierTypeStateIssuer
372395000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031209000726 FL Practitioner - Family Practice 2163328378 Reassigns benefits to 2 organizations
Receives reassigned benefits from 2 practitioners
Practice locations: Bonifay, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 E Wisconsin Ave
Bonifay, FL 32425-1809
Phone (850) 547-2209

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 638-1610

1410 Brickyard Rd
Chipley, FL 32428-5966
Phone (850) 638-3400

5429 College Dr
Graceville, FL 32440-1858
Phone (850) 263-0639

925 Carlisle Rd
Chipley, FL 32428-4360
Phone (850) 638-9399

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Pathology Group of Northwest Florida PLLC Current Accepting new patients
Northwest Florida Healthcare, Inc Current Accepting new patients
Holmes County Hospital Corp CurrentSince Mar 1, 1995 Accepting new patients
Northwest Florida Healthcare, Inc CurrentSince Oct 15, 2019 Accepting new patients
Vivid Pathology PA Current Accepting new patients
Northwest Florida Healthcare, Inc. CurrentSince Oct 15, 2019 Accepting new patients
Holmes County Hospital Corp CurrentSince Mar 1, 1995 Accepting new patients
Heritage Family Medicine, LLC Family Medicine PastSince Apr 8, 2013 Accepting new patients

Locations

101 E Wisconsin Ave
Bonifay, FL 32425
Phone (850) 547-2209

2600 Hospital Dr
Bonifay, FL 32425
Phone (850) 416-6484

1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300

Interoperability endpoints

  • Direct secure messaging: leisa.bailey.1@14612.direct.athenahealth.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 9

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 4

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1851314330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E WISCONSIN AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324251809",
            "telephone_number": "850-547-2209",
            "fax_number": "850-547-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WISCONSIN AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324251809",
            "telephone_number": "850-547-2209",
            "fax_number": "850-547-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "LEISA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0063592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372395000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

Sources for this page

Verify at the official NPI Registry.