Individual provider Active NPI

Contresia Ladonna Bailey, M.D.

  • Family Medicine Physician
  • Tucker, GA
National Provider Identifier
1871518951
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
057042 Issued in GA
Practice address
1462 Montreal Rd
Ste 303
Tucker, GA 30084-6929
Phone
(770) 938-9761
Fax
(770) 938-6509
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A102071 CA
Family Medicine Physician 207Q00000X 19333 MS
Family Medicine Physician 207Q00000X 057042 GA Primary

Addresses

Primary practice location

1462 Montreal Rd
Ste 303
Tucker, GA 30084-6929

Mailing address

1462 Montreal Rd
Ste 303
Tucker, GA 30084-6929
Phone (770) 938-9761

Other identifiers 1

IdentifierTypeStateIssuer
003140252AMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A102071CAMDFamily Medicine Physician
057042GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Past Accepting new patients
North Harper Minor Medical Clinic, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1871518951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD",
            "address_2": "STE 303",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846929",
            "telephone_number": "770-938-9761",
            "fax_number": "770-938-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD",
            "address_2": "STE 303",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846929",
            "telephone_number": "770-938-9761",
            "fax_number": "770-938-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "CONTRESIA",
        "middle_name": "LADONNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A102071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19333",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003140252A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.