Individual provider Active NPI

Kenneth M. Bailey, MD

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1851351472
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME94058 Issued in FL
Practice address
12210 Bruce B Downs Blvd
Tampa, FL 33612-9211
Phone
(865) 985-7186
NPI assigned
Mar 27, 2006
Last updated
Jul 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 043420 CT
Diagnostic Radiology Physician 2085R0202X ME94058 FL Primary
Diagnostic Radiology Physician 2085R0202X 056261 GA
Diagnostic Radiology Physician 2085R0202X 36113410 IL
Diagnostic Radiology Physician 2085R0202X 01060500A IN
Diagnostic Radiology Physician 2085R0202X 39378 KY
Diagnostic Radiology Physician 2085R0202X 224194 MA
Diagnostic Radiology Physician 2085R0202X 200500649 NC
Diagnostic Radiology Physician 2085R0202X 25MA07974400 NJ
Diagnostic Radiology Physician 2085R0202X 35086092 OH
Diagnostic Radiology Physician 2085R0202X MD426019 PA
Diagnostic Radiology Physician 2085R0202X 0101238049 VA
Diagnostic Radiology Physician 2085R0202X 21414 WV

Addresses

Primary practice location

12210 Bruce B Downs Blvd
Tampa, FL 33612-9211

Mailing address

12210 Bruce B Downs Blvd
Tampa, FL 33612-9211
Phone (865) 985-7186

Other identifiers 1

IdentifierTypeStateIssuer
518461891AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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
056261GAMDDiagnostic Radiology Physician
36113410ILMDDiagnostic Radiology Physician
01060500AINMDDiagnostic Radiology Physician
39378KYMDDiagnostic Radiology Physician
200500649NCMDDiagnostic Radiology Physician
25MA07974400NJMDDiagnostic Radiology Physician
35086092OHMDDiagnostic Radiology Physician
0101238049VAMDDiagnostic Radiology Physician
21414WVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pin Point Radiology Practice Group, PA Diagnostic Radiology PastSince Sep 1, 2009 Accepting new patients
Metroamerican Radiology Consultants P a Diagnostic Radiology Past Accepting new patients
Optimal Readings Professional Services, LLC Diagnostic Radiology Past Accepting new patients
Pin Point Radiology Management, L.P. Diagnostic Radiology PastSince Aug 1, 2008 Accepting new patients
Team Radiology Physicians, PA Diagnostic Radiology Past Accepting new patients

Organizations & group practices 5

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1851351472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12210 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129211",
            "telephone_number": "865-985-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12210 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129211",
            "telephone_number": "865-985-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KENNETH",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "043420",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME94058",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "056261",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36113410",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01060500A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "39378",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "224194",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200500649",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA07974400",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35086092",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD426019",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101238049",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "21414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518461891A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.