Individual provider Active NPI

Philip Clay Bryan, MD

  • Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1104828359
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9273 Issued in OK
Practice address
1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone
(405) 340-2346
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9273 OK
Surgery Physician 208600000X 9273 OK Primary

Addresses

Primary practice location

1000 N Lee Ave
Oklahoma City, OK 73102-1036

Mailing address

1515 Tower Dr
Moore, OK 73160-6181
Phone (405) 310-0836

Other practice location 1

305 S 5th St
Enid, OK 73701-5832
Phone (580) 548-5010

Other identifiers 1

IdentifierTypeStateIssuer
100000560AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040327000206 OK Practitioner - General Surgery 7315839958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Woundcare Center LLCGroup PAC ID 6406296300, 6 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-4200

305 S 5TH St
Enid, OK 73701-5832
Phone (580) 548-5010

8324 S Walker Ave
Oklahoma City, OK 73139-9450
Phone (405) 473-6866

Hospital & facility affiliations

  • St Mary'S Regional Medical Center Hospital, Enid, OK, CCN 370026
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue433

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Philip C Bryan MD PLLC Surgery CurrentSince Aug 13, 2013 Accepting new patients
Allied Woundcare Center LLC CurrentSince Apr 8, 2024 Accepting new patients
Uhs of Oklahoma, LLC Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Poplar Bluff Hma Physician Management, LLC Surgery Past Accepting new patients

Locations

305 S 5th St
Enid, OK 73701
Phone (580) 233-6100

1515 Tower Dr
Moore, OK 73160

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

8324 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 473-6866

2401 W Wrangler Blvd
Seminole, OK 74868
Phone (405) 303-4000

Interoperability endpoints

  • Direct secure messaging: phil.bryan.1@17372.direct.athenahealth.com
  • Direct secure messaging: pbryan09@yourcarecommunity.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1104828359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 TOWER DR",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731606181",
            "telephone_number": "405-310-0836",
            "fax_number": "405-758-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-340-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737015832",
            "country_code": "US",
            "telephone_number": "580-548-5010",
            "fax_number": "580-548-5012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "PHILIP",
        "middle_name": "CLAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "9273",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "9273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000560A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.