Bryan Myers MD PC
Organization Active NPI Obstetrics & Gynecology Physician · Winchester, TN
NPI 1316258809 · NPPES record last updated Jun 30, 2010
Key facts
- NPI
- 1316258809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- BRYAN MYERS MD PC
- Practice address
- 161 Shirley Dr
Winchester, TN 37398-2256 - Phone
- (931) 962-0450
- Fax
- (931) 962-0470
- NPI assigned
- Jun 29, 2010
- Organization subpart
- No
Authorized official
- Name
- Bryan C. Myers
- Title
- MD
- Phone
- (931) 962-0450
Practitioners 5
-
Saharra D Jewell, APN
-
Bryan C Myers, MD
-
Caitlyn Schollmeier, CNM, MSN
-
Ruth A Shipley, CNM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2002707 | Bryan Myers MD PC | Provider-performed microscopy | Jan 24, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101015000378 | TN | Part B Supplier - Clinic/Group Practice | 7214120872 |
Receives reassigned benefits from 4 practitioners Practice locations: Manchester, TN; Tullahoma, TN; Winchester, TN |
National Provider Directory
Locations
1402 Willow Dr
Manchester, TN 37355
Phone (931) 450-1000
100 Hunters Ln
Ste 100B
Tullahoma, TN 37388
Phone (931) 393-4700
106 Westside Dr
Ste A
Tullahoma, TN 37388
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
161 Shirley Dr
Winchester, TN 37398-2256
Mailing address
161 Shirley Dr
Winchester, TN 37398-2256
Phone (931) 962-0450
Other providers in Winchester, TN
- Connie Lou Bristol
- Deanna Joyce Britton
- Esme Herholdt Brown
- Lloyd Keith Brown
- Mindy Brown
- Michelle Katherine Bull
- Albert V Bystritski
- Charlene A Campbell
- Caresouth HHA Holdings of Winchester LLC
- Carol H Wallace
All providers in Winchester, TN · Obstetrics & Gynecology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.