Individual provider Active NPI

Caroline M Bailey, PA

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1851331714
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
328 Issued in SC
Practice address
1 Bishop Gadsden Way
Suite 97
Charleston, SC 29412-3506
Phone
(843) 406-2362
Fax
(843) 406-2364
NPI assigned
Jun 8, 2006
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 328 SC Primary

Addresses

Primary practice location

1 Bishop Gadsden Way
Suite 97
Charleston, SC 29412-3506

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
0824PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20090602000050 SC Practitioner - Physician Assistant 2365591948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
328SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2009 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2009 Accepting new patients
Lowcountry Medical Associates Past Accepting new patients

Locations

1 Bishop Gadsden Way
Ste 97
Charleston, SC 29412
Phone (843) 406-2362

2270 Ashley Crossing Dr
Ste 165
Charleston, SC 29414
Phone (843) 556-6882

2270 Ashley Crossing Dr
Ste 170
Charleston, SC 29414
Phone (843) 763-3700

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1851331714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BISHOP GADSDEN WAY",
            "address_2": "SUITE 97",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123506",
            "telephone_number": "843-406-2362",
            "fax_number": "843-406-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0824PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.