Tara Kelly Bryan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP3044612 Issued in FL

Practice address

1890 Lpga Blvd
Suite 200
Daytona Beach, FL 32117-7138

Phone

(386) 274-1744

Fax

(386) 274-1644

NPI assigned

Jul 24, 2006

Last updated

Jul 28, 2010By the provider in NPPES

Sex

Female

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

State licenses

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.

• Halifax Anesthesiology Associates PA

  • Anesthesiology Physician
  • Daytona Beach, FL
  • NPI 1639194590
  NPD (past)
• Volusia Anesthesia Associates

  • Anesthesiology Physician
  • Daytona Beach, FL
  • NPI 1205862992
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1417979808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 210",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177138",
            "telephone_number": "386-274-1744",
            "fax_number": "386-274-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177138",
            "telephone_number": "386-274-1744",
            "fax_number": "386-274-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "TARA",
        "middle_name": "KELLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3044612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawndolyn Bruten
• Bryan M Bergens DDS PA
• Tenisha Bryan Morris
• Lisa Tracy Ann Bryan Ukawuilulu, APRN
• James M Bryan, MD
• Branden Deshawn Bryant
• Jessica Fillyaw Buccolo, LCSW
• Susan Ricardo Buckley, ND
• Stephanie Lee Buddemeyer, APRN FNP-C
• Tyvion Isaiah Buford

• Certified Registered Nurse Anesthetist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.