NPIMap

Individual provider Active NPI

Michael Lee Bryant, MD

  • Family Medicine Physician
  • McKenzie, TN
National Provider Identifier
1154324960
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD35345 Issued in TN
Practice address
205 Hospital Dr Ste a
MC Kenzie, TN 38201-1649
Phone
(731) 352-7907
Fax
(731) 352-4459
NPI assigned
May 24, 2005
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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 MD35345 TN Primary

Addresses

Primary practice location

205 Hospital Dr Ste a
MC Kenzie, TN 38201-1649

Mailing address

205 Hospital Dr
Ste a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other practice location 1

201 N Brewer St
Paris, TN 38242-4027
Phone (731) 415-3574

Other identifiers 3

IdentifierTypeStateIssuer
103G706510OtherTNMEDICARE GROUP
3874136MedicaidTN
3380640OtherTNMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060810000511 TN Practitioner - Family Practice 2062415128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin HealthGroup PAC ID 5193070613, 9 clinicians

Practice addresses (Care Compare)

143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD35345TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Health Current Accepting new patients
Martin Health Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Martin Hospital Company LLC Family Medicine Past Accepting new patients
McKenzie Medical Center, PC Family Medicine Past Accepting new patients
McKenzie Medical Center PC Family Medicine Past Accepting new patients
Martin Health Past Accepting new patients
Shiloh Emergency Physicians LLC Past Accepting new patients

Locations

143 Kennedy Dr
Martin, TN 38237
Phone (731) 587-5321

1135 Broadway St
South Fulton, TN 38257
Phone (731) 479-2606

1135 Broadway St
Ste A
South Fulton, TN 38257
Phone (731) 479-2606

Interoperability endpoints

  • Direct secure messaging: mbryant17957@directepic.wth.org

Organizations & group practices 7

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 8

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1154324960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "STE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR STE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 N Brewer St",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TN",
            "postal_code": "382424027",
            "country_code": "US",
            "telephone_number": "731-415-3574",
            "fax_number": "731-240-0232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD35345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "103G706510",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3874136",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McKenzie, TN

Sources for this page

Verify at the official NPI Registry.