MEDICARE: DR. ASHA LENORA BAILEY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	1541	SC
2	207RN0300X	Nephrology Physician	6022	TN
3	207RN0300X	Nephrology Physician	34462	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619156957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHA LENORA BAILEY DO

Provider Business Mailing Address
First Line	:	121 PARK CENTRAL DR STE 200
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6476
Country	:	US
Telephone Number	:	803-252-9907
Fax Number	:	803-252-9906

Provider Business Practice Location Address
First Line	:	121 PARK CENTRAL DRIVE
Second Line	:	SUITE 200
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	803-252-9907
Fax Number	:	803-252-9906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	12/15/2025

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