Lisa Bryan

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10127 Issued in FL

Practice address

5015 29TH Ave W
Bradenton, FL 34209-6119

Phone

(941) 795-4025

NPI assigned

Aug 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Cortez House Inc

  • Assisted Living Facility
  • Bradenton, FL
  • NPI 1942964622
  NPD (past)

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1447650528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 51ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095031",
            "telephone_number": "941-795-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 29TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342096119",
            "telephone_number": "941-795-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140259500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce P Dorman MD PA
• Melody Mae Brumbaugh, COTA
• Jessica Brumit
• Christine E Bruzek, MS, OTR/L
• Bryan J Morgan PA
• Michelle L. Bryan, ARNP
• Bryant Psychological Services, Inc
• William Eric Bryant
• Leann Jane Buchanan
• Sabrina Buchanczenko

• All providers in Bradenton, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.