Jan Leslie Bacon, A.P.R.N.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R0040808 Issued in OK

Practice address

700 Wall St
Norman, OK 73069

Phone

(405) 360-7337

Fax

(866) 259-0044

NPI assigned

Nov 21, 2005

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Victor T. Wilson MD PC

  • Pediatrics Physician
  • Norman, OK
  • NPI 1477633121
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1891778122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N PORTER AVE",
            "address_2": "SUITE 310",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716424",
            "telephone_number": "405-579-1653",
            "fax_number": "405-360-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WALL ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73069",
            "telephone_number": "405-360-7337",
            "fax_number": "866-259-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JAN",
        "middle_name": "LESLIE",
        "credential": "A.P.R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0040808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus W. Ayers, B.S.
• Norman Paul Ayers, MD
• Nilufer Safiya Aziz, M.P.A.
• Raz Azmar
• Heather A. Babione, OTA
• Shelly Renae Bacon
• Stephanie Badaroux, PA-C
• Kale David Baden, D.PH.
• Chad A Bagg, O.D.
• Annie Torossian Baghdayan, M.ED, BCBA

• Nurse Practitioner in Norman, OK
• Providers in Norman, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.