Trisha Danielle Bacon, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

06890 Issued in OR

Practice address

2645 N 17TH St
Coos Bay, OR 97420

Phone

(541) 266-3658

NPI assigned

Aug 20, 2010

Last updated

Jul 24, 2014By 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 names 1

• Trisha Danielle Macconnell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1538475140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "97420",
            "telephone_number": "541-266-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "97420",
            "telephone_number": "541-266-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "TRISHA",
        "middle_name": "DANIELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "06890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISHA",
            "last_name": "MACCONNELL",
            "middle_name": "DANIELLE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Paul Aurich, DO
• Charles R. Axelton, R.PH.
• Baaake
• Mallory Babcock
• Terrance Bach, M.D.
• William Harrison Bacon III, DMD PC
• Sylvia Anne Bailey-Allen, RN
• Patricia Annette Bailey
• Ryan Reed Bailey, D.D.S.
• John Bain, PT

• Orthopedic Physical Therapist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Orthopedic Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.