Connie Marie Bryan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28133795A Issued in IN

Practice address

210 S Michigan St
Suite 110
South Bend, IN 46601-2094

Phone

(574) 243-5108

Fax

(574) 243-0185

NPI assigned

Jul 28, 2014

Last updated

Jul 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• On-Site Health Solutions

  • Nursing Care Agency
  • South Bend, IN
  • NPI 1265840623
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1093123630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MICHIGAN ST",
            "address_2": "SUITE 110",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012094",
            "telephone_number": "574-243-5108",
            "fax_number": "574-243-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MICHIGAN ST",
            "address_2": "SUITE 110",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012094",
            "telephone_number": "574-243-5108",
            "fax_number": "574-243-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28133795A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704274591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Bruneel, OTR
• Mary Joan Brunner
• Seth David Brunner, DPT
• Ashley Brunt, LSW
• Randy Joseph Brush, P.A.
• Geraldne F Bryan, MSW, LCSW
• Nancy Bryant, LCSW
• Janiah Buchanon, RBT
• Kaedon Izaac Buchmiller, DO
• Richard C Buck, M.D.

• Registered Nurse in South Bend, IN
• Providers in South Bend, IN by specialty
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.