Gregory J Bacon, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Springfield, MO
NPI 1619616299 · NPPES record last updated Aug 20, 2026
Key facts
- NPI
- 1619616299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2026014312 (MO)
- Practice address
- 630 W Kearney St
Springfield, MO 65803-2508 - Phone
- (417) 761-5000
- NPI assigned
- Jun 1, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2885 W Battlefield St
Springfield, MO 65807-3952
PO Box
Kansas City, MO 64184
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260415000910 | MO | Practitioner - Clinical Social Worker | 0244706547 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026014312 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2026014312 | MO | Yes |
Addresses
Primary practice location
630 W Kearney St
Springfield, MO 65803-2508
Mailing address
PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | MO |
Other providers in Springfield, MO
- Natalie Azevedo
- Joseph G. Babin
- Steven Paul Baca
- Erin McKenzie Bachus
- Stacey Back
- McKenzie T Bacon
- Tylor Bacon
- Marwa Sultan Badawy
- Kevin Paul Baehl
- Jack M Bagby
All providers in Springfield, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.