Individual provider Active NPI

Michael Buzzle Bryant, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Greensboro, NC
National Provider Identifier
1174867972
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2784 Issued in NC
Practice address
3719 Sherbourne LN
Greensboro, NC 27405
Phone
(336) 338-0567
NPI assigned
Nov 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2784 NC Primary

Addresses

Primary practice location

3719 Sherbourne LN
Greensboro, NC 27405

Mailing address

3719 Sherbourne LN
Greensboro, NC 27405-3448
Phone (336) 338-0567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2784NCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1174867972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 SHERBOURNE LN",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053448",
            "telephone_number": "336-338-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 SHERBOURNE LN",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27405",
            "telephone_number": "336-338-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MICHAEL",
        "middle_name": "BUZZLE",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.