1982742656 NPI number — SHARON SHEREE JOYCE-BAILEY MD

Table of content: SHARON SHEREE JOYCE-BAILEY MD (NPI 1982742656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982742656 NPI number — SHARON SHEREE JOYCE-BAILEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOYCE-BAILEY
Provider First Name:
SHARON
Provider Middle Name:
SHEREE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOYCE
Provider Other First Name:
SHARON
Provider Other Middle Name:
SHEREE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982742656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 116156
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30368-6156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-312-5525
Provider Business Mailing Address Fax Number:
770-339-2120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1942 ATKINSON RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30043-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-775-0600
Provider Business Practice Location Address Fax Number:
678-377-5284
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  050770 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4083329 . This is a "CIGNA HEALTHCARE OF GA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 0701012 . This is a "UNITED HEALTHCARE OF GA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 5266652 . This is a "AETNA NON-HMO" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 160055146 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000927858 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2689941 . This is a "AETNA HMO" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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