Jessica Bacon

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

COA.15424 Issued in OH

Practice address

1 Childrens PLZ
Dayton, OH 45404-1873

Phone

(937) 641-3414

NPI assigned

Feb 25, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1821413063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "COA.15424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra K Back, RN
• Barynia Fernande Backeljauw, MD
• Camryn Backman
• Andrew Michael Bacon, MS, AT, ATC
• Elizabeth Ann Bacon, D.O.
• Joshua Logan Bacon, DO
• John B Badcock, DO
• Kyrie Eleyson R Baden, PHARMD
• M Catherine Bader
• Michael Badger, CASE MANAGER

• Critical Care Neonatal Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Critical Care Neonatal Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.