Healthcare Provider Details

I. General information

NPI: 1619156957
Provider Name (Legal Business Name): ASHA LENORA BAILEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 PARK CENTRAL DRIVE SUITE 200
COLUMBIA SC
29203
US

IV. Provider business mailing address

121 PARK CENTRAL DR STE 200
COLUMBIA SC
29203-6476
US

V. Phone/Fax

Practice location:
  • Phone: 803-252-9907
  • Fax: 803-252-9906
Mailing address:
  • Phone: 803-252-9907
  • Fax: 803-252-9906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number1541
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number6022
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number34462
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: