Jeffrey P Bacon

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

JEFFREY P BACON

Practice address

5442 Longley LN
Reno, NV 89511-3297

Phone

(916) 305-6345

NPI assigned

Apr 1, 2024

Organization subpart

No

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

Authorized official

Name

Jeffrey P Bacon, MDNPI 1215910757

Title

Owner

Phone

(916) 305-6345

Specialties & licenses 2

Addresses

Other names 1

• GRANITE PULMONARY MEDICINE Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Paul Bacon, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Reno, NV
  • NPI 1215910757
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1821840273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5442 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113297",
            "telephone_number": "916-305-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5442 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113297",
            "telephone_number": "916-305-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY P BACON",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-305-6345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANITE PULMONARY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRANITE PULMONARY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonja Jefferson
• Jeffery Andersen, PC
• Jeffrey D. Ferris, O.D., P.C.
• Jeffrey K Beall MD LLC
• Jeffrey M. Lilyhorn D.D.S., P.C.
• Jeffrey Zollinger D O PC
• Jordan Jegge
• James Charles Jempsa, D.O.
• Andre Jendresen
• Andrew William Jenison, DC

• Pulmonary Disease Physician in Reno, NV
• Providers in Reno, NV by specialty
• Pulmonary Disease Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.