Bryan Scott Lebo, DNP, ARNP, FNP
Individual provider
Active NPI
Family Nurse Practitioner · Spokane, WA
NPI 1043822372 · NPPES record last updated Aug 18, 2020
Key facts
- NPI
- 1043822372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP61091392 (WA)
- Practice address
- 9425 N Nevada St Ste 300
Spokane, WA 99218-1286
- Phone
- (509) 270-0065
- NPI assigned
- Aug 18, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20210701003024 |
WA |
Order and Referring Only - Nurse Practitioner |
4688075385 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|
| AP61091392 | WA | MD | Family Nurse Practitioner |
Practice roles
Interoperability endpoints
- Direct secure messaging: bryan.lebo.1@28854.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Multi-Specialty Clinic/Center |
261QM1300X |
|
|
|
| Durable Medical Equipment & Medical Supplies |
332B00000X |
|
|
|
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP |
363LF0000X |
AP61091392 |
WA |
Yes |
Addresses
Primary practice location
9425 N Nevada St Ste 300
Spokane, WA 99218-1286
Mailing address
9425 N Nevada St Ste 300
Spokane, WA 99218-1286
Phone (509) 270-0065
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| AP61091392 | Medicaid | WA | |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| Other URL |
Spokane |
|
|
| Other URL |
Spokane |
|
|
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- Bronson Matthias Leclair, MD
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- Tim Ledbetter, LMHC
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All providers in Spokane, WA
· Family Nurse Practitioner in Washington