Opal M Bacon, PHARMD

Primary specialty

Psychiatric PharmacistTaxonomy code 1835P1300X

License

5302044753 Issued in MI

Practice address

1 Ford Place, 1C
Outpatient Psychiatry
Detroit, MI 48202

Phone

(313) 556-7882

Fax

(313) 874-6650

NPI assigned

Nov 21, 2016

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Interoperability endpoints

• Direct secure messaging: obacon420629@direct.hfhs.org

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1285177493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 ANITA AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FORD PLACE, 1C",
            "address_2": "OUTPATIENT PSYCHIATRY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-556-7882",
            "fax_number": "313-874-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "OPAL",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "MI",
            "license": "5302044753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasam Mary Bachuri, MD
• Carly Paige Bachus, DDS
• Brian N. Bachynski, M.D.
• Frank Baciewicz Jr., MD
• Alcesa Abelgas Backos, MD FAAP
• Rhonda Bacon
• Tameka N Bacon, PHARMD
• Alshaima Badani Badani
• Nahwa Badawi
• Linley Badder, NNP-BC

• Psychiatric Pharmacist in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric Pharmacist in Michigan

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