Tiffani S Bacon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP039211T-MD Issued in MD

Practice address

5930 Cornerstone CT W Ste 300
San Diego, CA 92121-3772

Phone

(866) 687-7390

NPI assigned

Dec 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• Fox Rehabilitation Services of South Carolina, LLC

  • Physical Therapist
  • Lexington, SC
  • NPI 1902133689
  Medicare reassignment NPD
• Ivyrehab Focus, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Lake Wylie, SC
  • NPI 1518105279

  Physical Therapist

  Medicare reassignment NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1629568647

  Physical Therapist

  Medicare reassignment NPD
• Private Therapy Services LLC

  • Physical Therapist
  • Charleston, SC
  • NPI 1346381092
  Medicare reassignment NPD
• Reinvent Health Inc

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1215763206

  Physical Therapist, SC

  Medicare reassignment NPD
• Prava PC

  • Physical Therapist
  • Chicago, IL
  • NPI 1841003753

  SC

  Medicare reassignment
• Ivyrehab Focus, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Rock Hill, SC
  • NPI 1902443880
  NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD
• Tri-County Therapy, LLC

  • Speech-Language Pathologist
  • Ladson, SC
  • NPI 1447591607

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773532800000",
    "number": "1407911381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 CORNERSTONE CT W STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 CORNERSTONE CT W STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213772",
            "telephone_number": "866-687-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "TIFFANI",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2026-03-15",
        "certification_date": "2026-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9900",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SC",
            "license": "10015",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10015",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "9900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "CP039211T-MD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00405932",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH2249",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPACT PT LICENSURE",
            "identifier": "CP039211T-MD",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Nicole Bacon
• Elizabeth Bacon, PHD
• Meriah Bacon, PHARMD, RPH
• Molly Bacon
• Sarah Elizabeth Bacon
• Bactes Imaging Solution
• Helen A. Baczkowski, AGPCNP-BC
• Michellini Omari Badagliacco-Cabrera
• Kristen Mary Badal, MOTR/L
• Trinity Badal

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.