Bruce Richard Bacon, RN

Primary specialty

Rehabilitation Registered NurseTaxonomy code 163WR0400X

License

122292-30 Issued in WI

Practice address

5000 W National Ave
Milwaukee, WI 53295-0001

Phone

(414) 384-2000

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720097371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 W GLEN HILLS CT",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093353",
            "telephone_number": "414-540-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "BRUCE",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "WI",
            "license": "122292-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caila Marie Bachmann
• Kathleen Alice Bachmann
• Cole Bacig, DO
• Jennifer Backes, MSN, RN, AG-CNS
• Melissa Backus, PHARMD
• Rachel Evelyn Bacon, LCSW
• Danielle Bade, PA
• Melissa Christine Badertscher, LPC
• Badger Acquisition of Wisconsin, LLC
• Badger Healthcare Agency, LLC

• Rehabilitation Registered Nurse in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Rehabilitation Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.