NPIMap

Organization Active NPI

Bryant Family Medical Clinic, P.a.

  • Medical Specialty Clinic/Center
  • Bryant, AR
National Provider Identifier
1073640769
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MC2196 Issued in AR
Legal business name
BRYANT FAMILY MEDICAL CLINIC, P.A.
Practice address
408 Office Park Dr Ste 3
Bryant, AR 72022-7536
Phone
(501) 847-2835
Fax
(501) 847-6809
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Gaelle Bryant
Title
Business Manager
Phone
(501) 804-9712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MC2196 AR Primary

Addresses

Primary practice location

408 Office Park Dr Ste 3
Bryant, AR 72022-7536

Mailing address

408 Office Park Dr Ste 3
Bryant, AR 72022-7536
Phone (501) 847-2835

Other practice location 1

610 W Commerce St
Bryant, AR 72022-7514
Phone (501) 847-2835

Other identifiers 1

IdentifierTypeStateIssuer
MC2196OtherARARKANSAS STATE MEDICAL BO

National Provider Directory

National Provider Directory

Locations

610 W Commerce Dr
Bryant, AR 72022
Phone (501) 847-2835

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1073640769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 OFFICE PARK DR STE 3",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227536",
            "telephone_number": "501-847-2835",
            "fax_number": "501-847-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 OFFICE PARK DR STE 3",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227536",
            "telephone_number": "501-847-2835",
            "fax_number": "501-847-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 W Commerce St",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AR",
            "postal_code": "720227514",
            "country_code": "US",
            "telephone_number": "501-847-2835",
            "fax_number": "501-847-6809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRYANT FAMILY MEDICAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "GAELLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "501-804-9712"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AR",
            "license": "MC2196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL BO",
            "identifier": "MC2196",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.