Jessica Lynn Bacon, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NA Issued in FL

Practice address

13495 Gulf Blvd
Madeira Beach, FL 33708-2515

Phone

(727) 391-4100

Fax

(727) 398-2067

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1275761033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-391-4100",
            "fax_number": "727-398-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-391-4100",
            "fax_number": "727-398-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Christine Alcauskas, M.D.
• Joseph M Ault
• Candice Sapiro Barsky, M.A.
• Angela Annette Basso, MS, LMHC
• Bayfront Medical Supply LLC
• Shirley Berkery, R.N.
• Dana K Buechner, FNP BC

• Family Medicine Physician in Madeira Beach, FL
• Providers in Madeira Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.