Kassandra Bryan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-57590 Issued in FL

Practice address

9200 NW 39TH Ave Ste 130-1020
Gainesville, FL 32606-7331

Phone

(352) 623-1807

NPI assigned

Aug 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Bridgeway Agency, LLC

  • Behavior Analyst
  • Melrose, FL
  • NPI 1962156281
  NPD Authorized official
• Embrace Community Center Inc

  • Developmentally Disabled Services Day Training Agency
  • Keystone Heights, FL
  • NPI 1457871204
  NPD Authorized official

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1235749599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 NW 39TH AVE STE 130-1020",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067331",
            "telephone_number": "352-623-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KASSANDRA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-22-57590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bruno Jr., MD
• Kathleen Bruno
• Marshall Brunson, LMT
• Crystal Alonzo Bryan, APRN
• Jaimie Lynn Bryan
• Kay M. Bryan
• Stephanie N Bryan, PA
• Shirley Ann Bryant Smith
• Derriyle Emani Bryant-Galloway
• Andrew Bryant, MD

• Behavior Analyst in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.