Kelsey Bryan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2083292 Issued in TX

Practice address

1901 Medi Park Dr
Suite 2048
Amarillo, TX 79106-2110

Phone

(806) 353-2101

Fax

(806) 353-2674

NPI assigned

Sep 15, 2015

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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.

• Epic Health Services, Inc.

  • Home Health Agency
  • Houston, TX
  • NPI 1407922701
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1265801773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE LOOP 820",
            "address_2": "BUSINESS TOWER 1, SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760537209",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "SUITE 2048",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-353-2101",
            "fax_number": "806-353-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KELSEY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2083292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Baca PA
• Benjamin Brue, PTA
• Jill Brue, LPC
• Henry David Bruton, MD
• James D Bryan, M.D.
• Denise Renee Bryant, RN
• Sharon M Bryant, CPNP
• Kylee Bryen
• Bsa Amarillo Diagnostic Clinic
• Bsa Amarillo Diagnostic Clinic Inc

• Physical Therapy Assistant in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.