JORDAN LYLE BAILEY (NPI# 1225124936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225124936 |
| Entity Type | Individual |
| Full Name | JORDAN LYLE BAILEY |
| Credential | M.D. |
| Practice Address |
151 N 4th Ave Suite B Pocatello ID 83201-6300 |
| Practice Telephone | 2082697147 |
| Practice Fax Number | 2084166522 |
| Mailing Telephone | 2082697147 |
| Mailing Fax Number | 2084166522 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M9245 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS | 76704 | 01 |
| ID | 807222600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904373 | Jordan R. Bailey | Music Therapist | 6117 Bianca Cir Apt 284, Fort Worth, TX 76132-2898 | 2018-06-01 |
| 1417596198 | Jordan Bailey | Specialist/Technologist | 216 W Union St, Minden, LA 71055-3216 | 2019-12-30 |
| 1376198267 | Jordan Bailey | Social Worker | 1601 Brenner Ave, Salisbury, NC 28144-2515 | 2019-08-07 |
| 1457852543 | Jordan Wayne Bailey | Behavior Technician | 496 Old Route 66, Saint Robert, MO 65584-3728 | 2018-02-23 |
| 1841702875 | Jordan Michael Bailey | Physician Assistant | 3409 Worth St Ste 300, Dallas, TX 75246-2039 | 2017-10-31 |
| 1700281060 | Jordan Daniel Bailey | Behavioral Analyst | 1832 W Liberty St, Ann Arbor, MI 48103-4148 | 2014-10-29 |
| 1689016677 | Jordan Broderick Bailey | Specialist/Technologist, Other | 6100 Maddry Oaks Ct, Raleigh, NC 27616-3156 | 2013-07-19 |
| 1750507372 | Jordan Bailey | Nurse Practitioner | 3908 Old Buckingham Rd, Powhatan, VA 23139-5753 | 2007-04-18 |
| Street Address |
151 N 4TH AVE SUITE B |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407392178 | Addison Grisaffi | Chiropractor | 151 N 4th Ave, Pocatello, ID 83201-6300 | 2017-01-18 |
| 1124197702 | Specialized Family Medicine | Family Medicine | 151 N 4th Ave, Suite B, Pocatello, ID 83201-6300 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891234332 | Clair Enterprises Inc | Family Medicine | 2552 Oneida St, Pocatello, ID 83201-2145 | 2017-02-16 |
| 1124406186 | Michael A Anderson | Family Medicine | 1000 Pocatello Creek Rd Ste E10, Pocatello, ID 83201-2953 | 2015-05-11 |
| 1093078578 | Sharla Clark | Family Medicine | 1951 Bench Road, Suite B, Pocatello, ID 83201-4008 | 2012-06-20 |
| 1508194580 | Jared M Kam | Family Medicine | 353 N 4th Ave Ste 102, Pocatello, ID 83201-6391 | 2009-12-02 |
| 1417118787 | Lavonne R. Mills, Md | Family Medicine | 3307 N Stephanie Rd, Pocatello, ID 83204-7285 | 2008-06-19 |
| 1801926035 | Jack Pearson Summers | Family Medicine | 5418 W Buckskin Rd, Pocatello, ID 83201-9126 | 2007-03-06 |
| 1053483669 | Mountain View Family Medicine, Inc | Family Medicine | 2006 Birdie Thompson Dr, Pocatello, ID 83201-2768 | 2006-11-15 |
| 1093884363 | Jared Michael Price | Family Medicine | 1951 Bench Rd Ste B, Pocatello, ID 83201-2073 | 2006-11-08 |
| 1396796199 | Gary Walker Kearl | Family Medicine | 444 Hospital Way Suite 801, Pocatello Va Outpatiend Clinic, Pocatello, ID 83201 | 2006-05-15 |
| 1841285590 | Kyle L Clifford | Family Medicine | 2006 Birdie Thompson Drive, Pocatello, ID 83201 | 2005-09-19 |
| Find all providers in POCATELLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.