John Alan Baccus, RT, CRT-NPS, RST

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Practice address

5000 El Dorado Parkway, Suite 150
Box 312
Frisco, TX 75033

Phone

(940) 391-7155

NPI assigned

Jan 24, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1093138265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 EL DORADO PARKWAY, SUITE 150",
            "address_2": "BOX 312",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 EL DORADO PARKWAY, SUITE 150",
            "address_2": "BOX 312",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033",
            "telephone_number": "940-391-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "credential": "RT, CRT-NPS, RST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Frisco, TX
• Providers in Frisco, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.