Active NPI
Jonathan Bryan
- Community Health Worker
- Los Angeles, CA
National Provider Identifier
1306969019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 5715 S Broadway
Los Angeles, CA 90037-4131 - Phone
- (323) 948-0444
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
5715 S Broadway
Los Angeles, CA 90037-4131
Mailing address
5715 S Broadway
Los Angeles, CA 90037-4131
Phone (323) 948-0444
Other practice location 1
562 S San Pedro St
Los Angeles, CA 90013
Phone (213) 488-9559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1306969019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5715 S BROADWAY",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900374131",
"telephone_number": "323-948-0444",
"fax_number": "323-948-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5715 S BROADWAY",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900374131",
"telephone_number": "323-948-0444"
}
],
"practiceLocations": [
{
"address_1": "562 S San Pedro St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90013",
"country_code": "US",
"telephone_number": "213-488-9559",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRYAN",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.