Active NPI
Melissa M Bailey, ARNP
- Nurse Practitioner
- Tampa, FL
National Provider Identifier
1992793004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP663562
- Practice address
- 4202 E Fowler Ave
Shs100
Tampa, FL 33620-6750 - Phone
- (813) 974-2331
- Fax
- (813) 974-5888
- NPI assigned
- Oct 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP663562 | FL | |
| Nurse Practitioner | 363L00000X | ARNP663562 | FL | Primary |
Addresses
Primary practice location
4202 E Fowler Ave
Shs100
Tampa, FL 33620-6750
Mailing address
PO Box 917770
Orlando, FL 32891-7770
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 301642100 | Medicaid | FL | |
| Y0155 | Other | FL | BLUE CROSS BLUE SHIELD |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9107076 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 10 To 10 Urgent Care, LLC | Current | Accepting new patients |
Locations
24420 State Road 54
Lutz, FL 33559
Phone (813) 948-2453
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.
-
- Urgent Care Clinic/Center
- Lutz, FL
- NPI 1932368495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1992793004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328917770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 E FOWLER AVE",
"address_2": "SHS100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336206750",
"telephone_number": "813-974-2331",
"fax_number": "813-974-5888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "MELISSA",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-12",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP663562",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP663562",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "301642100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y0155",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.