Individual provider Active NPI

Bryson Simpson, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1104792704
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP312496 Issued in GA
Practice address
3014 N Patterson St
Valdosta, GA 31602-1711
Phone
(229) 262-6815
Fax
(229) 219-1790
NPI assigned
Oct 13, 2025
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP312496 GA Primary

Addresses

Primary practice location

3014 N Patterson St
Valdosta, GA 31602-1711

Mailing address

172 Fletcher St
Morven, GA 31638-2445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260121004169 GA Practitioner - Nurse Practitioner 1951888999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwell Ambulatory IncGroup PAC ID 9234566779, 11 clinicians

Practice addresses (Care Compare)

3014 N Patterson St
Valdosta, GA 31602-1711
Phone (229) 262-6815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP312496GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwell Ambulatory Inc CurrentSince Jan 1, 2026 Accepting new patients
Southwell Ambulatory Inc CurrentSince Jan 1, 2026 Accepting new patients
Southwell Ambulatory Inc Past Accepting new patients

Locations

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

3014 N Patterson St
Valdosta, GA 31602
Phone (229) 242-0194

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1104792704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 FLETCHER ST",
            "city": "MORVEN",
            "state": "GA",
            "postal_code": "316382445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021711",
            "telephone_number": "229-262-6815",
            "fax_number": "229-219-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "BRYSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NP312496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.