Individual provider Active NPI

Christopher Gary Bryant

  • Pediatrics Physician
  • Aiken, SC
National Provider Identifier
1093389546
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL86148 Issued in SC
Practice address
215 Town Creek Rd
Aiken, SC 29803-5843
Phone
(803) 508-7651
Fax
(803) 508-7655
NPI assigned
May 19, 2021
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL86148 SC Primary

Addresses

Primary practice location

215 Town Creek Rd
Aiken, SC 29803-5843

Mailing address

215 Town Creek Rd
Aiken, SC 29803-5843
Phone (803) 508-7651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809003269 SC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8628472925

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Doctors LLC Past Accepting new patients

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1093389546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 TOWN CREEK RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035843",
            "telephone_number": "803-508-7651",
            "fax_number": "803-508-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TOWN CREEK RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035843",
            "telephone_number": "803-508-7651",
            "fax_number": "803-508-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "CHRISTOPHER",
        "middle_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL86148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.