JAMES P. BACON (NPI# 1063413474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063413474 |
| Entity Type | Individual |
| Full Name | JAMES P. BACON |
| Credential | M.D. |
| Practice Address |
335 Glessner Ave Mansfield OH 44903-2269 |
| Mailing Address |
5400 Frantz Rd Suite 250 Dublin OH 43016-4144 |
| Practice Telephone | 4195248151 |
| Mailing Telephone | 6145446356 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2015-11-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35-05-0204-B | OH | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35.050204 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0687092 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972953263 | James Wesley Bacon | Occupational Therapist | 1770 S Rock Rd Apt 810, Wichita, KS 67207-5177 | 2016-06-16 |
| 1811496672 | James Benjamin Bacon | Clinic/Center | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2018-02-07 |
| 1790173573 | James Bacon | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2015-01-02 |
| 1295055796 | James David Bacon | Anesthesiology | University of Kentucky, 800 Rose Street, Lexington, KY 40536-0293 | 2010-06-07 |
| 1982684619 | James Bacon | Emergency Medicine | 1325 Broadway St, Rockport, TX 78382-3333 | 2006-01-19 |
| Street Address |
335 GLESSNER AVE |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44903-2269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203153 | Jose Joaquin Norberto | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2005-05-23 |
| 1902404643 | Brian George | Pharmacist | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-10-14 |
| 1407460165 | Andrea Joyce Lankester | Physician Assistant | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-09-01 |
| 1780298422 | Garrett Brendan Stough | Nurse Anesthetist, Certified Registered | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-09-01 |
| 1629696802 | Medcentral Health System | Pharmacy | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-07-14 |
| 1982231775 | Deidra Carolina Momeyer | Nurse Practitioner | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-03-24 |
| 1144857772 | Fabiana Patino | Nurse Practitioner | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2020-03-24 |
| 1144868910 | Amanda Marie Mcmullen | Nurse Practitioner | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2019-12-12 |
| 1144862566 | Marissa Catherine Lacey | Physician Assistant | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2019-10-17 |
| 1891347258 | Kassandra Lee Robinson | Nurse Practitioner | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2019-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710495304 | Meredith Remy | Specialist/Technologist | 864 St. Rt. 314 S, Mansfield, OH 44903 | 2018-01-17 |
| 1639695174 | Judd Mateo | Home Health Aide | 1027 Neil Circle N., Mansfield, OH 44903 | 2017-08-16 |
| 1942722517 | Leighana Nichole Smith | Licensed Practical Nurse | 1451 Lucas Rd., Mansfield, OH 44903 | 2017-07-14 |
| 1528481710 | Sarah Elizabeth Hoffman | Occupational Therapy Assistant | 1600 Crider Rd., Mansfield, OH 44903 | 2014-01-24 |
| 1881025195 | Erica Renee Hanley | Occupational Therapy Assistant | 1600 Crider Road, Mansfield, OH 44903 | 2013-12-12 |
| 1164768917 | Colette Elaine Germann | Licensed Practical Nurse | 695 Satinwood N Cr, Mansfield, OH 44903 | 2012-12-26 |
| 1386996577 | Nicky Lynn Cole | Home Health Aide | 135 Columbia Avenue, Mansfield, OH 44903 | 2012-10-11 |
| 1215217989 | Darein Lee Wilson | Nurse's Aide | 175 Colonial Drive, Mansfield, OH 44903 | 2011-08-25 |
| 1205070802 | Simone Nannette Robinson | Licensed Practical Nurse | 576 Garfield Place, Mansfield, OH 44903 | 2009-04-27 |
| 1659518991 | Amelia Faye Johnson Grund | Nurse Practitioner | 336 Glessner Ave, Mob 2nd Fl, Mansfield, OH 44903 | 2009-01-08 |
| Find all providers in zip 44903 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306878863 | Medcentral Professional Association Inc. | Internal Medicine | 308 Glessner Ave, Mansfield, OH 44903-2225 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799347 | Warren Endovascular Associates LLC | Internal Medicine | 1950 Niles Cortland Rd Ne Ste 12, Warren, OH 44484-1077 | 2020-08-07 |
| 1821570128 | Rishi Puri | Internal Medicine | 9500 Euclid Ave # J2-208, Cleveland, OH 44195-0001 | 2018-09-04 |
| 1760980049 | Cardiac Cin of Columbus LLC | Internal Medicine | 175 S 3rd St Ste 200-248, Columbus, OH 43215-5134 | 2018-01-31 |
| 1316445695 | Cardiac Cin of Cincinnati LLC | Internal Medicine | 9435 Waterstone Blvd Ste 140-302, Cincinnati, OH 45249-8226 | 2018-01-31 |
| 1720462591 | Midwest Access Services LLC | Internal Medicine | 7335 Yankee Rd Ste 101, Liberty Township, OH 45044-0008 | 2015-07-12 |
| 1629077961 | Gregory J Wood | Internal Medicine | 7200 Mentor Ave, Mentor, OH 44060-7522 | 2005-07-19 |
| 1508865213 | Joseph Michael Surmitis | Internal Medicine | 4082 Fulton Dr Nw, Canton, OH 44718-2866 | 2005-07-15 |
| 1851396428 | Puvi N Seshiah | Internal Medicine | 3219 Clifton Ave, Suite 400, Cincinnati, OH 45220-3027 | 2005-06-20 |
| 1669474839 | David G Bichsel | Internal Medicine | 745 W State St, Ste 750, Columbus, OH 43222-1515 | 2005-06-01 |
| 1427656420 | Sarah Nicole Blair | Internal Medicine | 13207 Ravenna Rd, Chardon, OH 44024-7032 | 2020-10-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.