Individual provider Active NPI

Elizabeth Bryant, NP

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1194445858
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1064915 Issued in TX
Practice address
11811 N Tatum Blvd Ste 1075
Phoenix, AZ 85028-1661
Phone
(866) 986-2263
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1064915 TX Primary

Addresses

Primary practice location

11811 N Tatum Blvd Ste 1075
Phoenix, AZ 85028-1661

Mailing address

200 S Park Rd Ste 200
Hollywood, FL 33021-8541
Phone (866) 986-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220922001806 TX Practitioner - Nurse Practitioner 8921483280 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1064915TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab Consultants PLLC Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Woundtech of Texas CurrentSince Sep 19, 2022 Accepting new patients

Locations

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1626 W Baker Rd
Baytown, TX 77521
Phone (281) 628-7300

940 York Dr
Desoto, TX 75115
Phone (972) 331-4554

12001 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 434-3800

11353 Sugar Park Ln
Sugar Land, TX 77478
Phone (281) 276-2050

2450 E 5th St
Tyler, TX 75701
Phone (903) 592-6745

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15880/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1194445858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S PARK RD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218541",
            "telephone_number": "866-986-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 N TATUM BLVD STE 1075",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281661",
            "telephone_number": "866-986-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1064915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.