Melissa M Bacon, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

24598 Issued in MS

Practice address

113 McRae PT
Madison, MS 39110-6579

Phone

(507) 250-7030

NPI assigned

Aug 25, 2006

Last updated

Feb 22, 2017By 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 1

Addresses

Other identifiers 1

Other names 1

• Melissa M Nunn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1356458012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MCRAE PT",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106579",
            "telephone_number": "507-250-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MCRAE PT",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106579",
            "telephone_number": "507-250-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "24598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09336744",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "NUNN",
            "middle_name": "M",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rebecca Bagwell, RDN, LDN
• Elizabeth Baird
• Jean Baker, PHARM.D
• Caroline Tate Baldwyn, PA-C
• Bethany P Ball, NP

• Obstetrics & Gynecology Physician in Madison, MS
• Providers in Madison, MS by specialty
• Obstetrics & Gynecology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.