NPIMap

Individual provider Active NPI

Johnny Lee O'Bryant II, CIT 3419 3/19/16

  • Addiction (Substance Use Disorder) Counselor
  • Baton Rouge, LA
National Provider Identifier
1417315946
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CIT 3419 Issued in LA
Practice address
4255 E Brookstown Dr
Baton Rouge, LA 70805-4603
Phone
(225) 927-0770
Fax
(225) 927-0771
NPI assigned
Jan 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CIT 3419 LA Primary

Addresses

Primary practice location

4255 E Brookstown Dr
Baton Rouge, LA 70805-4603

Mailing address

4255 E Brookstown Dr
Baton Rouge, LA 70805-4603
Phone (225) 927-0770

Other names 1

  • Mr. Johnny Lee O'Bryant II Professional name

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
CIT 3419LAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1417315946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708054603",
            "telephone_number": "225-927-0770",
            "fax_number": "225-927-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708054603",
            "telephone_number": "225-927-0770",
            "fax_number": "225-927-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYANT",
        "first_name": "JOHNNY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "CIT 3419 3/19/16",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "CIT 3419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNY",
            "last_name": "O'BRYANT",
            "middle_name": "LEE",
            "prefix": "MR.",
            "suffix": "II",
            "credential": "CIT 3419 03/31/2016",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.