Nickole A Bacon (NPI# 1215432224, PAC ID# 5092079533) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1215432224 |
| PAC ID by PECOS | 5092079533 |
| Professional Enrollment ID | I20180508002407 |
| Full Name | Nickole A Bacon |
| Organization Legal Name | BAYCARE MEDICAL GROUP, INC. |
| Address |
2525 Pasadena Ave S Suite U South Pasadena FL 33707-4559 |
| Phone Number | 7273601784 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6406753623 |
| Number of Group Practice Members | 610 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100075 | ST JOSEPHS HOSPITAL |
| 100126 | PALMS OF PASADENA HOSPITAL |
| 100067 | ST ANTHONY'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2461 Enterprise Rd, Suite C, Clearwater, FL 33763-1726 | 7277255060 | BAYCARE MEDICAL GROUP, INC. |
| 2525 Pasadena Ave S, Suite U, South Pasadena, FL 33707-4559 | 7273601784 | BAYCARE MEDICAL GROUP, INC. |
| Organization Legal Name | BAYCARE MEDICAL GROUP, INC. |
| Physicians | 577 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Gannon | Family Medicine | Baycare Medical Group, Inc. | 2531 Landmark Dr, Suite 103, Clearwater, FL 33761-3928 |
| Okwudili Okpaleke | Family Medicine | Baycare Medical Group, Inc. | 10141 Big Bend Rd, Suite 206, Riverview, FL 33578-7419 |
| Brian P Mcdaniel | Family Medicine | Baycare Medical Group, Inc. | 400 Pinellas St, Clearwater, FL 33756-3312 |
| Fred H Brennan Jr. | Family Medicine | Baycare Medical Group, Inc. | 807 N Myrtle Ave, Clearwater, FL 33755-4254 |
| Farshad Anvari | Thoracic Surgery | Baycare Medical Group, Inc. | 3003 W Dr Martin Luther King Jr Blvd, Mab 2nd Floor, Tampa, FL 33607-6307 |
| Thomas E Applegate | Hospitalist | Baycare Medical Group, Inc. | 6901 Simmons Loop, Suite 4, Riverview, FL 33578-9498 |
| Christopher N Nobo | Gastroenterology | Baycare Medical Group, Inc. | 2000 Osprey Blvd, Suite 110, Bartow, FL 33830-4347 |
| Jennifer Rebecca Chambers | Family Medicine | Baycare Medical Group, Inc. | 5405 Park N St, Saint Petersburg, FL 33709-1044 |
| Darryl B Bain | Nurse Practitioner | Baycare Medical Group, Inc. | 6633 Forest Ave, Suite 300, New Port Richey, FL 34653-2612 |
| Juan Martin Valdivia Valdivia | Neurosurgery | Baycare Medical Group, Inc. | 4726 N Habana Ave, Suite 103, Tampa, FL 33614-7144 |
| Street Address |
2525 PASADENA AVE S SUITE U |
| City | SOUTH PASADENA |
| State | FL |
| Zip | 33707-4559 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniela Uebelhart | Internal Medicine | Baycare Medical Group, Inc. | 2525 Pasadena Ave S, Suite U, South Pasadena, FL 33707-4559 |
| Neil Turk Feldman | Pulmonary Disease | 2525 Pasadena Ave S, Suite S, South Pasadena, FL 33707-4559 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott E Kapulskey | Geriatric Medicine | 7035 1st S Ave, Saint Petersburg, FL 33707-1203 | |
| Mark A Nowacki | Internal Medicine | 7011 1st Ave S, St Petersburg, FL 33707-1203 | |
| Rebeca Fajardo | Internal Medicine | Webber Primecare Medical Center LLC | 7035 1st S Ave, Saint Petersburg, FL 33707-1203 |
| Jane E Kienle | Geriatric Medicine | Dean A Bramlet M D P A | 7111 1st S Ave, Saint Petersburg, FL 33707-1223 |
| Christopher Joseph Leto | Otolaryngology | Select Physicians Alliance Pl | 6827 1st Ave S, Suite 100, St Petersburg, FL 33707-1242 |
| Timothy M Dunlevy | Otolaryngology | Pasadena Ent Pa | 6827 1st S Ave, Suite 100, Saint Petersburg, FL 33707-1242 |
| Skye Dorsett Quamina | Qualified Audiologist | Select Physicians Alliance Pl | 6827 1st Ave S, Suite 100, St Petersburg, FL 33707-1242 |
| Ricardo Requena | Otolaryngology | Select Physicians Alliance Pl | 6827 1st Ave S, Suite 100, St Petersburg, FL 33707-1242 |
| Calli Keenan Fodor | Qualified Audiologist | Select Physicians Alliance Pl | 6827 1st Ave S, Suite 100, St Petersburg, FL 33707-1242 |
| Helen L Techler | Qualified Audiologist | Select Physicians Alliance Pl | 6827 1st Ave S, Suite 100, St Petersburg, FL 33707-1242 |
| Find all physicians in zip 33707 | |||
| City | SOUTH PASADENA |
| Zip Code | 33707 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SOUTH PASADENA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Nickole A Bacon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.