CMS-1500 Box 24J / 33a • NPI
1760872865
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
190 E BANNOCK ST, BOISE, ID, 83712-6241
✓ 9-Digit EDI 837 ZIP+4 (83712-6241)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1760872865 (NYKOL BAILEY, CRNA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1760872865 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | NYKOL BAILEY, CRNA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 190 E BANNOCK ST, BOISE, ID, 83712-6241 |
| Practice Telephone / Fax | Tel: (435) 459-4194 |
| Administrative Mailing Address | 210 N SHIRTTAIL WAY, BLANDING, UT, 84511-3220 |
| Enumeration & Last Sync | Enumerated: 2015-01-27 | CMS Record Updated: 2022-09-30 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (NYKOL BAILEY, CRNA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: ID | License: 105690 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: ID | License: 70140 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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