Individual provider Active NPI

Vickie Lynn Bryan, OTR/L

  • Occupational Therapist
  • North Augusta, SC
National Provider Identifier
1407949308
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2450 Issued in SC
Practice address
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Phone
(803) 278-4272
Fax
(803) 278-1794
NPI assigned
Oct 2, 2006
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2450 SC Primary
Occupational Therapist 225X00000X 3190 GA

Addresses

Primary practice location

350 Austin Graybill Rd
North Augusta, SC 29860-9251

Mailing address

1097 Highway 220 W
Lincolnton, GA 30817-1724
Phone (706) 359-3307

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
3190GAMDDental Hygienist
2450SCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1407949308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 HIGHWAY 220 W",
            "city": "LINCOLNTON",
            "state": "GA",
            "postal_code": "308171724",
            "telephone_number": "706-359-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 AUSTIN GRAYBILL RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609251",
            "telephone_number": "803-278-4272",
            "fax_number": "803-278-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2450",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "3190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Augusta, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.