Individual provider Active NPI

James Bryant, CDCA

  • Substance Abuse Rehabilitation Facility
  • Warren, OH
National Provider Identifier
1356859177
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
169032 Issued in OH
Practice address
4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone
(330) 787-0955
NPI assigned
Jan 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 165267 OH
Substance Abuse Rehabilitation Facility 324500000X 169032 OH Primary

Addresses

Primary practice location

4930 Enterprise Dr NW
Warren, OH 44481-8706

Mailing address

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 787-0955

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

State licenses

LicenseStateTypeSpecialty
165267OHMDSubstance Abuse Rehabilitation Facility
169032OHMDSubstance Abuse Rehabilitation Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Past Accepting new patients
FSR of Parkman LLC PastSince Sep 18, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/thrivecounselingwarren/r4/
  • FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1356859177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-787-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-787-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JAMES",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "165267",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "169032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.