Individual provider Active NPI

Kristen Bacon, BSN, RN, EMTP

  • School Registered Nurse
  • Beavercreek, OH
National Provider Identifier
1861373284
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN.502663 Issued in OH
Practice address
2942 Dayton Xenia Rd
Beavercreek, OH 45434-6306
Phone
(937) 458-2549
Fax
(937) 429-7688
NPI assigned
Sep 11, 2025
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN.502663 OH Primary

Addresses

Primary practice location

2942 Dayton Xenia Rd
Beavercreek, OH 45434-6306

Mailing address

2942 Dayton Xenia Rd
Beavercreek, OH 45434-6306
Phone (937) 458-2549

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Emergency Medical Technician - Paramedic, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.502663OHMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1861373284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 DAYTON XENIA RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346306",
            "telephone_number": "937-458-2549",
            "fax_number": "937-429-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 DAYTON XENIA RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346306",
            "telephone_number": "937-458-2549",
            "fax_number": "937-429-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "KRISTEN",
        "credential": "BSN, RN, EMTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OH",
            "license": "RN.502663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

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.