James Wesley Bacon, OTR/L
Individual provider Active NPI Occupational Therapist · Wichita, KS
NPI 1972953263 · NPPES record last updated Jun 16, 2016
Key facts
- NPI
- 1972953263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 17-02894 (KS)
- Practice address
- 1770 S Rock Rd Apt 810
Wichita, KS 67207-5177 - Phone
- (316) 734-4508
- NPI assigned
- Jun 16, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-02894 | KS | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-02894 | KS | Yes |
Addresses
Primary practice location
1770 S Rock Rd Apt 810
Wichita, KS 67207-5177
Mailing address
1770 S Rock Rd Apt 810
Wichita, KS 67207-5177
Phone (316) 734-4508
Other providers in Wichita, KS
- Back to Health Chiropractic Center
- Back to Life Chiropractic and Acupuncture
- Back to Life Family Wellness LLC
- Lindsey Marie Backer-Fulghum
- David J Backes
- Alisa Leigh Baden
- Sabrina Marie Bader
- Robert Badgett
- Caitlyn Christine Badke
- Vanoohe Baer
All providers in Wichita, KS · Occupational Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.