Individual provider Active NPI

Darla Jean Bryan, RN, CS, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1083654073
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
085975 Issued in MO
Practice address
621 S New Ballas Rd
Suite 30163
Saint Louis, MO 63141-8232
Phone
(314) 251-6339
NPI assigned
Jun 7, 2006
Last updated
Jul 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 085975 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 30163
Saint Louis, MO 63141-8232

Mailing address

937 Justice CT
Florissant, MO 63034-2050
Phone (314) 837-3204

Other names 1

  • Darla Jean Bryan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000237 MO Practitioner - Nurse Practitioner 6709834013 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospitals East Communities CurrentSince Jun 1, 2004 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 4, 2014 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jun 1, 2004 Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

621 S New Ballas Rd
Ste 30163
Saint Louis, MO 63141
Phone (314) 251-6339

621 S New Ballas Rd
Ste 3016B
Saint Louis, MO 63141
Phone (314) 251-6339

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1083654073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 JUSTICE CT",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630342050",
            "telephone_number": "314-837-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 30163",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "DARLA",
        "middle_name": "JEAN",
        "credential": "RN, CS, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "085975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARLA",
            "last_name": "BRYAN",
            "middle_name": "JEAN",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.