Jacob Raymond Bryan, MOTR L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

815 S 200 W
Brigham City, UT 84302

Phone

(435) 723-5289

Fax

(435) 723-0579

NPI assigned

Nov 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Home Health Holdings, LLC

  dba Avalon Home Health

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1639536337
  NPD (past) Authorized official
• Hearthside Home Health Agency, Inc

  • Home Health Agency
  • Salmon, ID
  • NPI 1922030352
  NPD (past)
• Teton Home Health, LLC

  dba Avalon Home Health, LLC

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1003129073
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376619080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 E 350 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "435-730-5860",
            "fax_number": "435-723-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S 200 W",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "435-723-5289",
            "fax_number": "435-723-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "JACOB",
        "middle_name": "RAYMOND",
        "credential": "MOTR L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Ann Brown
• Brodey Brown
• Kloee Brown
• Luellen Brown, LCSW
• Raquel Bruderer
• Lance R Bryce, MD
• Shanua Buck
• Jared Buhler
• Bryson Lamont Bullough
• Stephanie Morgan Bullough

• Occupational Therapist in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.