Active NPI
Wendy Bacon
- Private Vehicle
- South Hill, VA
National Provider Identifier
1407323124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- T69-50-5052
- Practice address
- 260 Tiny Rd
South Hill, VA 23970-4916 - Phone
- (434) 917-4292
- Fax
- (434) 447-2604
- NPI assigned
- Oct 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T69-50-5052 | VA | Primary |
Addresses
Primary practice location
260 Tiny Rd
South Hill, VA 23970-4916
Mailing address
260 Tiny Rd
South Hill, VA 23970-4916
Phone (434) 917-4292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1407323124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 TINY RD",
"city": "SOUTH HILL",
"state": "VA",
"postal_code": "239704916",
"telephone_number": "434-917-4292",
"fax_number": "434-447-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 TINY RD",
"city": "SOUTH HILL",
"state": "VA",
"postal_code": "239704916",
"telephone_number": "434-917-4292",
"fax_number": "434-447-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACON",
"first_name": "WENDY",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "VA",
"license": "T69-50-5052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.