Active NPI
Kimberly Bryant
- Homemaker
- Logan, WV
National Provider Identifier
1336745660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 699 Stratton St
Logan, WV 25601-4020 - Phone
- (304) 752-6868
- Fax
- (304) 752-1047
- NPI assigned
- Dec 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | WV | Primary |
Addresses
Primary practice location
699 Stratton St
Logan, WV 25601-4020
Mailing address
PO Box 1346
Logan, WV 25601-1346
Phone (304) 752-6868
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": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1336745660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1346",
"city": "LOGAN",
"state": "WV",
"postal_code": "256011346",
"telephone_number": "304-752-6868",
"fax_number": "304-752-1047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 STRATTON ST",
"city": "LOGAN",
"state": "WV",
"postal_code": "256014020",
"telephone_number": "304-752-6868",
"fax_number": "304-752-1047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "WV",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.