Individual provider Active NPI

Timothy Allen Bryant, PHD

  • Marriage & Family Therapist
  • Williamsport, PA
National Provider Identifier
1396715520
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MF000005 Issued in PA
Practice address
1205 River Ave FL 2
Williamsport, PA 17701-3724
Phone
(570) 326-4118
Fax
(570) 326-5533
NPI assigned
Jan 23, 2006
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MF000005 PA Primary

Addresses

Primary practice location

1205 River Ave FL 2
Williamsport, PA 17701-3724

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 1

IdentifierTypeStateIssuer
1035097520001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240415001512 PA Practitioner - Marriage and Family Therapist 8123467834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

1205 River Ave
Suite 2
Williamsport, PA 17701-3724
Phone (570) 326-4118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC CurrentSince Jan 31, 2024 Accepting new patients
Family Practice Center, PC Marriage & Family Therapist CurrentSince Jan 31, 2024 Accepting new patients

Locations

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

1205 River Ave
#2
Williamsport, PA 17701
Phone (570) 323-5991

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1396715520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 RIVER AVE FL 2",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013724",
            "telephone_number": "570-326-4118",
            "fax_number": "570-326-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TIMOTHY",
        "middle_name": "ALLEN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035097520001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.