Individual provider Active NPI

Jennifer Bryant

  • Family Nurse Practitioner
  • Troy, MO
National Provider Identifier
1043729189
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021034486 Issued in MO
Practice address
1165 E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-1919
NPI assigned
Sep 20, 2017
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021034486 MO Primary

Addresses

Primary practice location

1165 E Cherry St
Troy, MO 63379-1520

Mailing address

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 528-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171024000817 IL Practitioner - Nurse Practitioner 7113293945
I20220316003331 MO Practitioner - Nurse Practitioner 7113293945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 528-7722

900 E Cherry St
Troy, MO 63379-1429
Phone (636) 528-8585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021034486MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Family Medicine, LLC CurrentSince Jan 1, 2021 Accepting new patients
Mercy Hospital Lincoln CurrentSince Mar 7, 2022 Accepting new patients
Greenville Family Medicine, LLC CurrentSince Jan 1, 2021 Accepting new patients
Mercy Hospital Lincoln CurrentSince Mar 7, 2022 Accepting new patients

Locations

1000 Red Ball Trl
Greenville, IL 62246
Phone (618) 391-6495

1165 E Cherry St
Troy, MO 63379
Phone (636) 528-1919

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECDGDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1043729189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-1919",
            "fax_number": "636-528-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021034486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.