Individual provider Active NPI

Kylie Renae Bailey, MSN, FNP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1982955563
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004059A Issued in IN
Practice address
615 N Michigan St
Employee Health
South Bend, IN 46601-1033
Phone
(800) 635-5516
Fax
(574) 647-6788
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71004059A IN Primary

Addresses

Primary practice location

615 N Michigan St
Employee Health
South Bend, IN 46601-1033

Mailing address

615 N Michigan St
Employee Health
South Bend, IN 46601-1033

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
71004059AINMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1982955563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "address_2": "EMPLOYEE HEALTH",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "address_2": "EMPLOYEE HEALTH",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "800-635-5516",
            "fax_number": "574-647-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KYLIE",
        "middle_name": "RENAE",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004059A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.