Individual provider Active NPI

John Russell Bailey, MD

  • Clinical Cardiac Electrophysiology Physician
  • Charlotte, NC
National Provider Identifier
1891793121
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
35578 Issued in NC
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3578
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35578 NC
Interventional Cardiology Physician 207RI0011X 35578 NC
Clinical Cardiac Electrophysiology Physician 207RC0001X 35578 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3578

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

1718 E 4th St
Ste 501
Charlotte, NC 28204-3261
Phone (704) 343-9800

Other identifiers 2

IdentifierTypeStateIssuer
N3578MedicaidSC
7912610MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbailey34981@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071214000600 NC Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4385734243 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians
Novant Health Matthews Medical Center LLCGroup PAC ID 6406845247, 76 clinicians

Practice addresses (Care Compare)

1401 Matthews Township Pkwy
Matthews, NC 28105-5403

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

15830 Ballantyne Medical PL
Suite 275
Charlotte, NC 28277-4791
Phone (980) 302-8659

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

401 Mocksville Ave
FL 2
Salisbury, NC 28144-2735
Phone (704) 633-9620

5145 Sellers Rd
Shallotte, NC 28470-3405

8201 Health Loop
Charlotte, NC 28215-7072

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair64

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
The Presbyterian Hospital Internal Medicine Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 19, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2016 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Feb 8, 2012 Accepting new patients
Novant Medical Group, Inc. CurrentSince Aug 1, 2007 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2007 Accepting new patients
Novant Health Ballantyne Medical Center LLC CurrentSince Aug 23, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
Novant Medical Group, Inc. Clinical Cardiac Electrophysiology Past Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

1718 E 4th St
Ste 501
Charlotte, NC 28204
Phone (704) 868-3256

125 Queens Rd
Ste 200
Charlotte, NC 28204

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1401 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 264-3500

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

8300 Health Park
Ste 107
Raleigh, NC 27615
Phone (919) 846-7312

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 9

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1891793121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043578",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E 4th St",
            "address_2": "Ste 501",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043261",
            "country_code": "US",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "35578",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "35578",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "35578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N3578",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7912610",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbailey34981@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1718 E 4th St",
            "address_2": "Ste 501",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.