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KIMBERLY S BACON NP
NPI 1215207451
Nurse Practitioner - Family in Johnson City, TN

Active since January 05, 2012
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604(423) 431-1810(423) 431-1811 Get Directions Write a Review

NPPES record last updated: January 26, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kimberly S Bacon Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY S BACON NP (NPI 1215207451) is an individual family provider in Johnson City, Tennessee, licensed in Tennessee (15209) and active in the NPI registry since January 2012.

NPPES Registry Identity

NPI1215207451
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIMBERLY S BACONCredential: NP
Location Address408 N STATE OF FRANKLIN RD, SUITE 24Johnson City, TN 37604-6089
Mailing Address408 N State Of Franklin Rd, Suite 24Johnson City, TN 37604-6089 · (423) 431-1810 · Fax (423) 431-1811
Phone(423) 431-1810
Fax(423) 431-1811
Sole ProprietorYes
Enumeration DateJanuary 5, 2012
Last NPPES UpdateJanuary 26, 2017
✔ NPI 1215207451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 15209
408 N STATE OF FRANKLIN RD, Johnson City, TN 37604
Open in Google Maps ↗

Other Identifiers 6

OtherP01200424TN · Railroad Medicare Pin
Medicaid7100195690KY
Medicaid1215207451NC
Medicare PIN103I506419TN
Medicaid7100195690VA
Medicaid1527812TN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAULA RENEE SMITH M.D.
Internal Medicine
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
MR. LARRY MICHAEL STEVENS II APN
Nurse Practitioner (Adult Health)
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
DR. SAMUEL WINSTON HUDDLESTON V M.D.
Radiology (Diagnostic Radiology)
408 N STATE OF FRANKLIN RD, SUITE 31
JOHNSON CITY, TN 37604
Washington County (423) 431-2478
ALEXIS HODGE DUTY FNP
Nurse Practitioner (Family)
408 N STATE OF FRANKLIN RD, SUITE 31B
JOHNSON CITY, TN 37604
Washington County (423) 431-4946
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Neurological Surgery
408 N STATE OF FRANKLIN RD, SUITE 42
JOHNSON CITY, TN 37604
Washington County (423) 431-2350
MRS. AMIE JARRETT BRIGGS FNP-BC
Nurse Practitioner
408 N STATE OF FRANKLIN RD, SUITE 31C
JOHNSON CITY, TN 37604
Washington County (423) 431-4946
DR. ANDREW S PIERCE MD
Internal Medicine
408 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-1810
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Internal Medicine (Gastroenterology)
408 N STATE OF FRANKLIN RD, SUITE 24
JOHNSON CITY, TN 37604
Washington County (423) 431-1810

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Bacon's NPI number?

The NPI number for Kimberly Bacon is 1215207451. It was assigned to this individual provider in the NPPES registry on January 5, 2012.

Where is Kimberly Bacon located?

Kimberly Bacon practices at 408 N State Of Franklin Rd Suite 24, Johnson City, TN 37604. The listed phone number is (423) 431-1810.

What is Kimberly Bacon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kimberly Bacon was last updated on January 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.