Stacey E Bacon, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

75561 Issued in KS

Practice address

1701 S Broadway St
Pittsburg, KS 66762-5856

Phone

(620) 235-4452

NPI assigned

Sep 25, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crawford County Mental Health CenterGroup PAC ID 3072955616, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crawford County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pittsburg, KS
  • NPI 1942064423

  KS

  Medicare reassignment Care Compare group NPD
• County of Crawford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pittsburg, KS
  • NPI 1215900899

  KS

  Medicare reassignment NPD
• Sunflower Mental Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Pittsburg, KS
  • NPI 1194459719
  NPD Authorized official
• Health & Family Services

  • Public Health or Welfare Agency
  • Pittsburg, KS
  • NPI 1801942578
  NPD
• County of Crawford

  • Community/Behavioral Health Agency
  • Pittsburg, KS
  • NPI 1982486742
  NPD (past)
• Psu Student Health Center

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1710273388
  NPD (past)
• Ali Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Joplin, MO
  • NPI 1376872879
  NPD (past)
• Cornerstone Medical, LLC

  • Internal Medicine Physician
  • Joplin, MO
  • NPI 1104549948
  NPD (past)
• Sjmgroup

  • Endocrinology, Diabetes & Metabolism Physician
  • Englewood, CO
  • NPI 1376590034
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1003066085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667625856",
            "telephone_number": "620-235-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667625856",
            "telephone_number": "620-235-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "STACEY",
        "middle_name": "E",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004015211",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "75561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ascension Via Christi Hospital Pittsburg, Inc.
• Ascension Via Christi Hospital Pittsburg, Inc.
• Dustin Lynn Ashmore, APRN
• Melissa Ann Austin, LMSW
• Lisa Ayala, MD
• Heather Lorraine Baima, ARNP
• Janel Marie Baker, PHARMD
• Michael P Baker, MD
• Rick M Baker, PHARMD
• Kimberly Balk

• All providers in Pittsburg, KS
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.