Michael Lee Bryant, MD
Individual provider Active NPI Family Medicine Physician · MC Kenzie, TN
NPI 1154324960 · NPPES record last updated Apr 30, 2018
Key facts
- NPI
- 1154324960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD35345 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 8
Medicare Care Compare profile
- 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 Health
Practice addresses (Care Compare)
143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321
Hospital & facility affiliations
- Adoration Home Health Martin
- Tennessee Quality Care - Home Health
- Amedisys Home Health Care
- Extendicare Home Health of Western TN
- Volunteer Community Hospital
- Jackson-Madison County General Hospital
- Baptist Memorial Hospital Union City
- Baptist Memorial Hospital - Carroll County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060810000511 | TN | Practitioner - Family Practice | 2062415128 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD35345 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Health | Family Medicine | Current |
Accepting new patients |
| Martin Health | Current | Accepting new patients | |
| Martin Health | Past | 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 |
| Shiloh Emergency Physicians LLC | Past | Accepting new patients |
Locations
143 Kennedy Dr
Martin, TN 38237
Phone (731) 587-5321
1135 Broadway St
Ste A
South Fulton, TN 38257
Phone (731) 479-2606
1135 Broadway St
South Fulton, TN 38257
Phone (731) 479-2606
Interoperability endpoints
- mbryant17957@directepic.wth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD35345 | TN | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3380640 | Other | TN | MEDICARE GROUP |
| 3874136 | Medicaid | TN | |
| 103G706510 | Other | TN | MEDICARE GROUP |
Other providers in MC Kenzie, TN
- Bethel Universtiy
- Bethel Universtiy
- Botanical Emergency Physicians, LLC
- Meredith Ann Brown
- Thomas E Brown
- Brittany Burkett
- Brooke Spivey Burress
- Kenneth T Butler
- Rustin Forest Cameron
- Elijah Carpenter
All providers in MC Kenzie, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.