KIMBERLY BACON (NPI# 1366818452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366818452 |
| Entity Type | Individual |
| Full Name | KIMBERLY BACON |
| Practice Address |
112 W Main St Purcell OK 73080-4220 |
| Mailing Address |
Po Box 662 Purcell OK 73080-0662 |
| Practice Telephone | 4055271785 |
| Practice Fax Number | 4055271084 |
| Mailing Telephone | 4055271785 |
| Mailing Fax Number | 4055271084 |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2015-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215207451 | Kimberly S Bacon | Nurse Practitioner | 408 N State of Franklin Rd, Suite 24, Johnson City, TN 37604-6089 | 2012-01-05 |
| 1487891065 | Kimberly Diane Bacon | Dental Assistant | 8381 La Palma Ave, Suite B & C, Buena Park, CA 90620-3271 | 2009-01-19 |
| 1205039542 | Kimberly Bacon | Social Worker | 50 Sanitorium Rd, Bldg F - Room 240, Pomona, NY 10970-3555 | 2007-06-06 |
| Street Address |
112 W MAIN ST |
| City | PURCELL |
| State | OK |
| Zip Code | 73080-4220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467923490 | Olivia Pierce | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2018-12-17 |
| 1528542271 | Amanda Taralee Mcreynolds | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2018-09-19 |
| 1144707142 | John Scott Conrad | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2018-07-23 |
| 1104334309 | Amanda Heij | Social Worker | 112 W Main St, Purcell, OK 73080-4220 | 2018-01-22 |
| 1801305545 | Rachel Chapman | Social Worker | 112 W Main St, Purcell, OK 73080-4220 | 2017-09-26 |
| 1801317987 | Lynn Davis | Community Health Worker | 112 W Main St, Purcell, OK 73080-4220 | 2017-06-29 |
| 1750833422 | Jessica Hernandez | Social Worker | 112 W Main St, Purcell, OK 73080-4220 | 2016-10-28 |
| 1023471638 | Tanya Wilson | Case Manager/Care Coordinator | 112 W Main St, Purcell, OK 73080-4220 | 2016-03-31 |
| 1831555341 | Jan Plavchak | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2016-01-13 |
| 1356684906 | Megan Killman | Rehabilitation Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2013-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255702981 | Clarissa Shomo | Social Worker | Outpatient Services Purcell- 1726 N. Green Ave, Strong Family Development, Purcell, OK 73080 | 2015-10-07 |
| 1992138614 | Crystal Nicole Navarro | Social Worker | 1726 N. Green Avenue, Purcell, OK 73080 | 2013-08-16 |
| 1417242595 | Jarod D. Allen | Behavioral Analyst | Outpatient Services-purcell-1726 N Green Ave, Strong Family Development, Purcell, OK 73080 | 2011-06-16 |
| 1508195397 | Custom Dental of Purcell, Pllc | Dentist | 700 Chandler Rd., Purcell, OK 73080 | 2009-12-08 |
| 1336387513 | Regina Gail Pereira | Counselor | Outpatient Servies Purcell- 1726 W Green Ave, Strong Family Development, Purcell, OK 73080 | 2009-01-27 |
| 1114182342 | Tenia Ladonna Skinner | Family Medicine | 129 N 3rd Ave Ste C, Purcell, OK 73080 | 2008-07-28 |
| 1164691234 | Carla D Parnacher | Counselor | 1726 N Green Ave Outpatient Services- Purcell, Strong Family Development, Norman, OK 73080 | 2008-02-22 |
| 1932319811 | Amanda Diane Harrington | Marriage & Family Therapist | 1438 Hardcastle Blvd., Medical Family Therapy, Purcell, OK 73080 | 2007-05-22 |
| 1215059464 | Purcell Chiropractic PC | Chiropractor | 1205 N Green Ave, Purcell, OK 73080 | 2007-04-06 |
| 1144365339 | Cynthia Inez Maynard | Marriage & Family Therapist | 1726 North Green Avenue, Strong Family Development-outpatient Services Purcell, Purcell, OK 73080 | 2007-02-21 |
| Find all providers in zip 73080 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881934313 | Marsha Lee Barger | Counselor | 702 N 8th Ave, Purcell, OK 73080-2030 | 2013-02-20 |
| 1083950331 | Melissa Thomason | Counselor | 801 W Lincoln St, Purcell, OK 73080-1638 | 2012-12-13 |
| 1336387513 | Regina Gail Pereira | Counselor | Outpatient Servies Purcell- 1726 W Green Ave, Strong Family Development, Purcell, OK 73080 | 2009-01-27 |
| 1760597272 | Brian G. Maynor | Counselor | 1726 N. Green Ave Outpatient Services- Purcell, Strong Family Development, Purcell, OK 73080 | 2006-08-21 |
| 1467923490 | Olivia Pierce | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2018-12-17 |
| 1528542271 | Amanda Taralee Mcreynolds | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2018-09-19 |
| 1831555341 | Jan Plavchak | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2016-01-13 |
| 1699089623 | Janet Schoenhals | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2010-08-02 |
| 1639317191 | Sarah Coley | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2009-01-21 |
| 1831248376 | James Ahern | Counselor | 112 W Main St, Purcell, OK 73080-4220 | 2007-01-10 |
| Find all providers in PURCELL | ||||
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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.