MRS. NICKOLE AIMEE BACON (NPI# 1215432224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215432224 |
| Entity Type | Individual |
| Full Name | MRS. NICKOLE AIMEE BACON |
| Credential | APRN-C |
| Practice Address |
2525 Pasadena Ave S Ste U South Pasadena FL 33707-4559 |
| Mailing Address |
2995 Drew St Fl 2 Clearwater FL 33759-3012 |
| Practice Telephone | 7273601784 |
| Practice Fax Number | 7273601823 |
| Mailing Telephone | 7275321355 |
| Mailing Fax Number | 8136352613 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2019-05-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN9365609 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
9365609 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 024515800 | 05 |
| Street Address |
2525 PASADENA AVE S STE U |
| City | SOUTH PASADENA |
| State | FL |
| Zip Code | 33707-4559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013475466 | Baycare Urgent Care, LLC | Pharmacy | 900 Carillon Parkway Ste 106, St. Petersburg, FL 33707 | 2019-03-05 |
| 1245754449 | S Dunkelberger Do LLC | Family Medicine | 6801 Gulfport Blvd S., Suite 6, Sout Pasadena, FL 33707 | 2017-07-29 |
| 1497196828 | Montego Mckinnon Sr. | Pharmacy Technician | 1501 Pasadena Shores Dr, St. Petersburg, FL 33707 | 2013-07-15 |
| 1558551580 | Linda K Barchie | Massage Therapist | 7230 Central Avenue, St Petersburg, FL 33707 | 2007-07-26 |
| 1487790770 | Margaret Helen Young | Dentist | 509 Pasadena Avenue South, St Petersburg, FL 33707 | 2007-01-30 |
| 1063567279 | Jack M Hafer | Dentist | 2525 Pasadena Ave S, Ste E, Pasadena, FL 33707 | 2007-01-25 |
| 1740331305 | Suncoast O2 Systems Inc. | Durable Medical Equipment & Medical Supplies | 5213 1st Avenue S, St. Petersburg, FL 33707 | 2007-01-12 |
| 1902987902 | Demekisa Sidamo Davis | Acupuncturist | 5301 Gulfport Blvd, Gulfport, FL 33707 | 2006-10-17 |
| 1689767691 | Mark A. Roberts | Family Medicine | 1240 81st Street South, St. Petersburg, FL 33707 | 2006-10-02 |
| 1457443004 | Darla Marie Keyes | Physical Therapist | 2825 Seabreeze Dr, Gulfport, FL 33707 | 2006-09-29 |
| Find all providers in zip 33707 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275913022 | Maria Posch | Nurse Practitioner | 1550 Pasadena Ave S, South Pasadena, FL 33707-3718 | 2015-06-08 |
| 1417910779 | Linda Mason | Nurse Practitioner | 1615 Pasadena Ave S, Suite 300, South Pasadena, FL 33707-4516 | 2006-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770340 | Ashley Mae Fleck | Nurse Practitioner | 3428 Sepia St, West Melbourne, FL 32904-7588 | 2020-11-08 |
| 1356942031 | Jorge Luis Ulloa Capestany | Nurse Practitioner | 6865 W 7th Ave Apt 408, Hialeah, FL 33014-4877 | 2020-11-08 |
| 1316548126 | Mitza Lacroix | Nurse Practitioner | 2670 Sw 83rd Ave, Miramar, FL 33025-7413 | 2020-11-06 |
| 1295336337 | Eduardo Wilfredo Loredo | Nurse Practitioner | 2930 Nw 156th St, Opa Locka, FL 33054-2226 | 2020-11-05 |
| 1962003004 | Yudaisy Salgueiro | Nurse Practitioner | 307 Nw 72nd Ave Apt 319, Miami, FL 33126-4304 | 2020-11-05 |
| 1992306146 | Nicole Lyn Burks | Nurse Practitioner | 11916 W Sample Rd, Coral Springs, FL 33065-4200 | 2020-11-04 |
| 1790386811 | Louise Lorraine Voltaire | Nurse Practitioner | 7728 Nw Greenspring St, Port St Lucie, FL 34987-3052 | 2020-11-04 |
| 1750982294 | Hyun-ae Kuh | Nurse Practitioner | 1628 Slash Pine Pl, Oviedo, FL 32765-6270 | 2020-11-02 |
| 1033719687 | Biviana Maria Arroyave | Nurse Practitioner | 2293 Ne 122nd St, North Miami, FL 33181-2910 | 2020-10-30 |
| 1831799790 | Jennmobilemed, Inc. | Nurse Practitioner | 631 Sw 17th Ct, Boca Raton, FL 33486-6413 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH PASADENA |
| Zip Code | 33707 |
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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.