Mona Mylene Baharestani, PHD, APN, CWOCN, CWS

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F301205-1 Issued in NY

Practice address

Lamont and Sydney St
Johnson City, TN 37684

Phone

(423) 926-1171

NPI assigned

Sep 10, 2007

Last updated

May 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1306031729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAMONT AND SYDNEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAMONT AND SYDNEY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHARESTANI",
        "first_name": "MONA",
        "middle_name": "MYLENE",
        "name_prefix": "Dr.",
        "credential": "PHD, APN, CWOCN, CWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F301205-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301205-1",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TN",
            "license": "1086300",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "TN",
            "license": "1086300",
            "primary": false
        },
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "TN",
            "license": "1086300",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "TN",
            "license": "1086300",
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NY",
            "license": "F301205-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey E. Bacon, M.S. CCC-SLP
• Charla Barefield Bacon, FNP-C
• Kimberly S Bacon, NP
• Paul Ryan Bader, PA
• Kristina Bagley
• Anne Bailey, R.P.H
• Brittany Ann Bailey, RN, SRNA
• Charisma Bailey, FNP-BC
• Christie Lee Bailey, NP
• Iain Matthew Bailey, M.D.

• Adult Health Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Adult Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.