Joselyn C Bacon, CNM

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R508381 Issued in MS

Practice address

350 W Woodrow Wilson Ave
Jackson, MS 39213-7681

Phone

(601) 364-2666

Fax

(601) 364-2659

NPI assigned

May 30, 2006

Last updated

Aug 28, 2008By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Midwife

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1811944077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 WEST WOODROW WILSON BLVD",
            "address_2": "HINDS COUNTY HEALTH DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39215",
            "telephone_number": "601-364-2666",
            "fax_number": "601-364-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-364-2666",
            "fax_number": "601-364-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JOSELYN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R508381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05603867",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• B&B Medical Supplies, Inc.
• Jay Tyler Babek, DO
• Katherine Claire Babin, MD
• Christina A Bach
• Kandis Vechelle Backus, PHARMD
• Olurotimi Badero, MD
• Courtney Bagge, PH.D.
• Courtney Baggett, COTA/L
• Kallye Baggett, MD
• Mercedes K Baggett, PCMHT

• Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.