Heather Marie Bacon, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1090055 Issued in TX

Practice address

3600 FM 1488 Rd Ste 200
Conroe, TX 77384-3867

Phone

(850) 776-3126

NPI assigned

Aug 19, 2022

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD
• Providence Physician Associates

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1760919880
  Medicare reassignment NPD
• Brazos Medical Center

  • Family Medicine Physician
  • Houston, TX
  • NPI 1811453293
  NPD (past)

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1306564844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S ACACIA PARK CIR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773821659",
            "telephone_number": "850-776-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FM 1488 RD STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773843867",
            "telephone_number": "850-776-3126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 S Loop 336 W Ste 115",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773043737",
            "country_code": "US",
            "telephone_number": "936-235-2825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACON",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1090055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Ryan Ayers, D.O.
• Ayhan PLLC
• Ayuk Grace Ayuk, PMHNP-BC
• Chungong Azefor, LVN
• Back Pain and Sciatica Center of Texas, PLLC
• Michelle Badensky, RD
• Jennifer Badillo
• Gladys Norys Baez-Perez, LCSW
• Larry Bailey, MA, LPC
• Isaac Bailon Martinez, DO

• Family Nurse Practitioner in Conroe, TX
• Providers in Conroe, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.