BRUCE RICHARD BACON, RN — NPI 1720097371 (Licensed & Credentialed Registered Nurse, Rehabilitation in MILWAUKEE, WI)

CMS-1500 Box 24J / 33a • NPI

1720097371

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163WR0400X

Licensed & Credentialed Registered Nurse, Rehabilitation

Box 32 Service Location & ZIP+4

5000 W NATIONAL AVE, MILWAUKEE, WI, 53295-0001

✓ 9-Digit EDI 837 ZIP+4 (53295-0001)

Practice Phone & Referral Fax

(414) 384-2000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720097371 (BRUCE RICHARD BACON, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1720097371` (NPI-1 Individual Practitioner)
Provider / Legal Name	BRUCE RICHARD BACON, RN
Plain-English Specialty	Licensed & Credentialed Registered Nurse, Rehabilitation NUCC Code: `163WR0400X` (Registered Nurse, Rehabilitation)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5000 W NATIONAL AVE, MILWAUKEE, WI, 53295-0001
Practice Telephone / Fax	Tel: (414) 384-2000
Administrative Mailing Address	2232 W GLEN HILLS CT, GLENDALE, WI, 53209-3353
Enumeration & Last Sync	Enumerated: 2006-08-05 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5000 W NATIONAL AVE, MILWAUKEE, WI, 53295-0001

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Plain-English Taxonomy & CMS Crosswalk (163WR0400X)

What Does Taxonomy Code 163WR0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WR0400X translates to:
"Licensed & Credentialed Registered Nurse, Rehabilitation"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Registered Nurse, Rehabilitation for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRUCE RICHARD BACON, RN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163WR0400X` — Registered Nurse, Rehabilitation Plain English: Licensed & Credentialed Registered Nurse, Rehabilitation	State: WI \| License: `122292-30` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRUCE RICHARD BACON, RN (NPI #1720097371)