=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164791372
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAILEY AND ASSOCIATES CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2011
-----------------------------------------------------
Last Update Date | 12/16/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5030 SOMERSET CT
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47201-3011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-627-6930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5030 SOMERSET CT
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47201-3011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-627-6930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JAMES M BAILEY
-----------------------------------------------------
Credential | MCD-CCC-SLP
-----------------------------------------------------
Telephone | 317-627-6930
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------