R Bacon Enterprises Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

FDA1835621 Issued in IN

Legal business name

R BACON ENTERPRISES INC

Practice address

2309 W Franklin St
Evansville, IN 47712

Phone

(812) 421-9112

Fax

(812) 421-9132

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Karen A Bacon

Title

Vice-President

Phone

(812) 897-1904

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Freedom Medical Doing business as

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144312133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 N BAKER ROAD",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476019509",
            "telephone_number": "812-897-1904",
            "fax_number": "812-897-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 W FRANKLIN ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47712",
            "telephone_number": "812-421-9112",
            "fax_number": "812-421-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R BACON ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "812-897-1904",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "FDA1835621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90009473",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000335185",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0742058",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001753100",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000335186",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACM",
            "identifier": "1023713",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY HEALTH PLAN",
            "identifier": "286867",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Eric Quinn, M.S., P.T.
• Sheri A Quinn, PT
• Alexa Quintero, MSW
• Hannah Quirey, MSW
• R Bacon Enterprises Inc
• Kayla N/a Rademacher, OTR/L
• Michele A Rahe
• Hydeh Rahimian, MD
• Nilofar Rahman, MD
• Rehan Rahman, DO

• Durable Medical Equipment & Medical Supplies in Evansville, IN
• Providers in Evansville, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.