Individual provider Active NPI

William Jeffrey Bryson, PH.D.

  • Clinical Psychologist
  • Huntsville, AL
National Provider Identifier
1083958813
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1792 Issued in AL
Practice address
250 Chateau Dr SW Ste 145
Huntsville, AL 35801-6437
Phone
(256) 801-8937
Fax
(256) 517-8355
NPI assigned
Nov 16, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1792 AL
Cognitive & Behavioral Psychologist 103TB0200X 1792 AL
Clinical Psychologist 103TC0700X 1792 AL Primary
Clinical Child & Adolescent Psychologist 103TC2200X 1792 AL
Health Service Psychologist 103TH0100X 1792 AL
Intellectual & Developmental Disabilities Psychologist 103TM1800X 1792 AL
Health Psychologist 103TH0004X 1792 AL

Addresses

Primary practice location

250 Chateau Dr SW Ste 145
Huntsville, AL 35801-6437

Mailing address

250 Chateau Dr SW Ste 145
Huntsville, AL 35801-6437
Phone (256) 801-8937

Other practice location 1

4800 Whitesport Cir SW
Suite 2
Huntsville, AL 35801-6444
Phone (256) 533-9393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130314000135 AL Practitioner - Clinical Psychologist 8022253335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

250 Chateau Dr SW
Suite 145
Huntsville, AL 35801-6437
Phone (256) 801-8937

875 Flat Shoals Rd SE
Suite 150
Conyers, GA 30094-6640
Phone (770) 785-7669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1792ALMDClinical Child & Adolescent Psychologist

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20621/brand/1/csg/1/fhir/r4

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, 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": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083958813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW STE 145",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016437",
            "telephone_number": "256-801-8937",
            "fax_number": "256-517-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW STE 145",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016437",
            "telephone_number": "256-801-8937",
            "fax_number": "256-517-8355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Whitesport Cir SW",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358016444",
            "country_code": "US",
            "telephone_number": "256-533-9393",
            "fax_number": "256-533-9690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "WILLIAM",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "1792",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AL",
            "license": "1792",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1792",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AL",
            "license": "1792",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "AL",
            "license": "1792",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "AL",
            "license": "1792",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AL",
            "license": "1792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.