Kelly J Bain, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

101371 Issued in MO

Practice address

901 Patients First Dr
Washington, MO 63090-4700

Phone

(636) 239-4100

Fax

(636) 390-4341

NPI assigned

Jun 10, 2006

Last updated

Sep 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.bain.p1@direct.essehealth.nextgenshare.com

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.

• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  Medicare reassignment NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment
• Mercy Clinic East Communities

  • Multi-Specialty Clinic/Center
  • Wildwood, MO
  • NPI 1164857397

  Family Medicine

  NPD
• Patients First Health Care LLC

  • Internal Medicine Physician
  • Washington, MO
  • NPI 1962441386

  Family Medicine

  NPD
• Patients First Health Care LLC

  • Cardiovascular Disease Physician
  • Fenton, MO
  • NPI 1356581078
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1982645818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-4100",
            "fax_number": "636-390-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-4100",
            "fax_number": "636-390-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "101371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080121864",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203380738",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01134656",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Austermann
• Axes Physical Therapy I, LLC
• Axes Physical Therapy I, LLC (Axes Physical Therapy)
• Bryce A Ayers, M.D.
• Tamara Bailey, FNP-C
• Alicia Caroline Baker, FNP
• Tim Baker, MD
• Audrey Grace Bales
• Karen A Balk, OT
• Jacquelyn N Ball, PT

• Family Medicine Physician in Washington, MO
• Providers in Washington, MO by specialty
• Family Medicine Physician in Missouri

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.