Individual provider Active NPI

Emily Elliott Bryce, PA-C

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1376264895
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
334156 Issued in LA
Practice address
1322 Kings Hwy
Shreveport, LA 71103-4225
Phone
(318) 626-4335
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 334156 LA Primary

Addresses

Primary practice location

1322 Kings Hwy
Shreveport, LA 71103-4225

Mailing address

1824 Jack Martin Rd
Minden, LA 71055-6556
Phone (318) 393-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120000457 LA Practitioner - Physician Assistant 5799156204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Family ClinicGroup PAC ID 1254660525, 3 clinicians

Practice addresses (Care Compare)

102 Office Park Dr
Minden, LA 71055-3086
Phone (318) 377-2885

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: premierfamilyclinic.emilybryce@132217.advancedmd-direct.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1376264895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 JACK MARTIN RD",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710556556",
            "telephone_number": "318-393-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034225",
            "telephone_number": "318-626-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYCE",
        "first_name": "EMILY",
        "middle_name": "ELLIOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "334156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.