Amy Lynne Bryan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002898B Issued in IN

Practice address

5311 Coldwater Rd
Wal-Mart Vision Center
Fort Wayne, IN 46825-5444

Phone

(260) 407-4150

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245316348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 GREEN HOLLY CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452018",
            "telephone_number": "260-490-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 COLDWATER RD",
            "address_2": "WAL-MART VISION CENTER",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255444",
            "telephone_number": "260-407-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002898B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Brunner
• Kristen Nicole Brunner, DDS
• Judith A Brunow, LMHC, MS
• Jessica Bruns, RBT
• Michelle Elizabeth Brunson, DPT
• Emily Nicole Bryan, M.A., CCC-SLP
• Julie Bryan, M.D.
• Cressilee Bryant, M.D.
• Javonuna Bryant
• Justin R Bryant, DO, MBA

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.