Individual provider Active NPI

Kristan J. Bryant, CNP

  • Adult Health Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1174963235
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.14667 Issued in OH
Practice address
8200 Mentor Hills Dr
Mentor, OH 44060-7861
Phone
(216) 938-2763
NPI assigned
Jul 3, 2013
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.14667 OH Primary

Addresses

Primary practice location

8200 Mentor Hills Dr
Mentor, OH 44060-7861

Mailing address

9488 Jackson St
Mentor, OH 44060-4514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130904000223 OH Practitioner - Nurse Practitioner 4587807938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.14667OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Physician Services of Ohio LLC CurrentSince Jun 5, 2024 Accepting new patients

Locations

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

3239 Jefferson Ave
Ste 1
Cincinnati, OH 45220
Phone (997) 991-9276

3366 Riverside Dr
Ste 103
Upper Arlington, OH 43221
Phone (617) 958-5697

9200 Worthington Rd
Ste 300
Westerville, OH 43082
Phone (614) 888-7800

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1174963235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9488 JACKSON ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 MENTOR HILLS DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607861",
            "telephone_number": "216-938-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KRISTAN",
        "middle_name": "J.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.14667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.