John W. Bacon M.D. PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

MD0000035633 Issued in TN

Legal business name

JOHN W. BACON M.D. PLLC

Practice address

300 Steam Plant Rd
Suite 210
Gallatin, TN 37066-3032

Phone

(615) 452-7223

Fax

(615) 452-3894

NPI assigned

Jun 6, 2007

Last updated

Apr 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John W Bacon, M.D.

Title

Dr Owner

Phone

(615) 452-7223

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1578766739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STEAM PLANT RD",
            "address_2": "SUITE 210",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663032",
            "telephone_number": "615-452-7223",
            "fax_number": "615-452-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STEAM PLANT RD",
            "address_2": "SUITE 210",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663032",
            "telephone_number": "615-452-7223",
            "fax_number": "615-452-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. BACON M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DR OWNER",
        "authorized_official_telephone_number": "615-452-7223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "MD0000035633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376661",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam James, MD
• Cameron S James, PHARMD
• Mackenzi Jankowics, BCBA, LBA
• Jeffrey Dan Jenkins, DPH
• Kimberly Suzanne Jenkins
• Ashley Johnson, PTA
• Christina Helen Johnson, PTA
• Hanna Johnson
• Jessica Ujjin Johnson, PHARMD
• Kerry Jean Johnson, B.A.

• Sports Medicine (Orthopaedic Surgery) Physician in Gallatin, TN
• Providers in Gallatin, TN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.