Individual provider Active NPI

Bailey Michelle Rickett, PA

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1902631955
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12995 Issued in GA
Practice address
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone
(706) 651-6105
Fax
(706) 868-1041
NPI assigned
Sep 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 12995 GA Primary

Addresses

Primary practice location

3651 Wheeler Rd
Augusta, GA 30909-6521

Mailing address

1616 Seaton Park
Montgomery, AL 36116-7236
Phone (417) 262-4221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250717002030 GA Practitioner - Physician Assistant 6305351388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

National Provider Directory

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

Organizations & group practices 1

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": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1902631955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SEATON PARK",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167236",
            "telephone_number": "417-262-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 WHEELER RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096521",
            "telephone_number": "706-651-6105",
            "fax_number": "706-868-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETT",
        "first_name": "BAILEY",
        "middle_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.