Individual provider Active NPI

Katelynn Elizabeth Bailey, DO

  • Emergency Medicine Physician
  • Watertown, SD
National Provider Identifier
1972023083
Registry record updated Jul 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12069 Issued in SD
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
Fax
(605) 882-7819
NPI assigned
Jun 21, 2017
Last updated
Jul 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2020

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 ED0690A WV
Emergency Medicine Physician 207P00000X 12069 SD Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

PO Box 1210
Watertown, SD 57201-6210
Phone (605) 882-7000

Other practice location 1

90 N 4th St
Martins Ferry, OH 43935-1648
Phone (740) 633-1100

Other practice location 2

2000 Eoff St
Wheeling, WV 26003-3823
Phone (304) 234-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, MT, AK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210401000195 WY Practitioner - Emergency Medicine 1153692710 Reassigns benefits to 1 organization
I20221206000535 MT Practitioner - Emergency Medicine 1153692710 Reassigns benefits to 3 organizations
I20240530001916 AK Practitioner - Emergency Medicine 1153692710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ED0690AWVMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
South Peninsula Hospital, Inc Current Accepting new patients
South Peninsula Hospital, Inc CurrentSince May 1, 2024 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients
CMSC, LLC CurrentSince Nov 19, 2022 Accepting new patients
South Peninsula Hospital, Inc. Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
St. John's Lutheran Hospital, Inc. CurrentSince Apr 1, 2026 Accepting new patients

Locations

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

209 Health Park Dr
Libby, MT 59923
Phone (406) 283-7000

2100 W Sunset Dr
Riverton, WY 82501
Phone (307) 856-4161

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sphosp-0c203fcf

Organizations & group practices 6

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1972023083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016210",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Martins Ferry",
            "state": "OH",
            "postal_code": "439351648",
            "country_code": "US",
            "telephone_number": "740-633-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Eoff St",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "260033823",
            "country_code": "US",
            "telephone_number": "304-234-0123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KATELYNN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": "ED0690A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "12069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.