Active NPI
Stephen R Bryant, MD
- Pediatrics Physician
- South Hill, VA
National Provider Identifier
1073589677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101026281
- Practice address
- 514 W Atlantic St
South Hill, VA 23970-1906 - Phone
- (434) 447-6969
- Fax
- (434) 447-8173
- NPI assigned
- Feb 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101026281 | VA | Primary |
Addresses
Primary practice location
514 W Atlantic St
South Hill, VA 23970-1906
Mailing address
514 W Atlantic St
South Hill, VA 23970-1906
Phone (434) 447-6969
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007610874 | Medicaid | VA | |
| 1073589677 | Medicaid | VA | |
| 007610327 | Medicaid | VA | |
| 010288134 | Medicaid | VA |
Other names 1
- Dr. Stephen R Bryant
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101026281 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Healthcare Corporation | Past | Accepting new patients | |
| Carilion Healthcare Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
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- NPI 1407667256
-
- Multi-Specialty Clinic/Center
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- NPI 1447206370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352419200000",
"number": "1073589677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 W ATLANTIC ST",
"city": "SOUTH HILL",
"state": "VA",
"postal_code": "239701906",
"telephone_number": "434-447-6969",
"fax_number": "434-447-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 W ATLANTIC ST",
"city": "SOUTH HILL",
"state": "VA",
"postal_code": "239701906",
"telephone_number": "434-447-6969",
"fax_number": "434-447-8173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "STEPHEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2012-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101026281",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007610874",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073589677",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007610327",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010288134",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHEN",
"last_name": "BRYANT",
"middle_name": "R",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in South Hill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.