Individual provider Active NPI

William Albert Bacon, CRNA

  • Registered Nurse
  • Hot Springs, AR
National Provider Identifier
1720002470
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R17265 Issued in AR
Practice address
3810 Central Ave
Ste H
Hot Springs, AR 71913-6921
Phone
(501) 525-5840
Fax
(501) 525-1762
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R17265 AR Primary
Certified Registered Nurse Anesthetist 367500000X C00387 AR

Addresses

Primary practice location

3810 Central Ave
Ste H
Hot Springs, AR 71913-6921

Mailing address

3810 Central Ave
Ste H
Hot Springs, AR 71913-6921
Phone (501) 525-5840

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R17265ARMDRegistered Nurse
C00387ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Lazerus Crna Ms Past Accepting new patients
Midstate Medical Services PA PastSince Aug 7, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1720002470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "address_2": "STE H",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136921",
            "telephone_number": "501-525-5840",
            "fax_number": "501-525-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "address_2": "STE H",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136921",
            "telephone_number": "501-525-5840",
            "fax_number": "501-525-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "WILLIAM",
        "middle_name": "ALBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R17265",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.