Individual provider Active NPI

Robert Ernest Bryant Jr., MD

  • Family Medicine Physician
  • Pinson, AL
National Provider Identifier
1124021472
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3335 Issued in AL
Practice address
4338 Main St
Pinson, AL 35126-3290
Phone
(205) 681-7902
Fax
(205) 680-3210
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3335 AL Primary

Addresses

Primary practice location

4338 Main St
Pinson, AL 35126-3290

Mailing address

4338 Main St
Pinson, AL 35126-3290
Phone (205) 681-7902

Other identifiers 1

IdentifierTypeStateIssuer
0000000007004MedicaidAL

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000442 AL Practitioner - Family Practice 4587792130 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3335ALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinson Medical Offices P.a. Family Medicine CurrentSince Jan 26, 2010 Accepting new patients

Locations

4338 Main St
Pinson, AL 35126
Phone (205) 680-7902

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1124021472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4338 MAIN ST",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263290",
            "telephone_number": "205-681-7902",
            "fax_number": "205-680-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4338 MAIN ST",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263290",
            "telephone_number": "205-681-7902",
            "fax_number": "205-680-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "ROBERT",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000007004",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinson, AL

Sources for this page

Verify at the official NPI Registry.