Individual provider Active NPI

Tiffany Ann Bryant, PA

  • Physician Assistant
  • Bowling Green, KY
National Provider Identifier
1467526723
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2931 Issued in KY
Practice address
1777 Ashley Cir
Bowling Green, KY 42104-3339
Phone
(270) 781-4090
Fax
(270) 842-3133
NPI assigned
Nov 20, 2006
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2931 KY Primary
Physician Assistant 363A00000X 1385 TN

Addresses

Primary practice location

1777 Ashley Cir
Bowling Green, KY 42104-3339

Mailing address

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228002220 KY Practitioner - Physician Assistant 9931207040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

1777 Ashley Cir
Bowling Green, KY 42104-3339
Phone (270) 781-4090

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone 2707815111270

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2931KYMDPhysician Assistant
1385TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Aug 1, 2024 Accepting new patients
Graves Gilbert Clinic PLLC Physician Assistant CurrentSince Aug 1, 2024 Accepting new patients

Locations

1325 Andrea St
Ste 100
Bowling Green, KY 42104
Phone (270) 901-3454

1777 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4090

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: tiffanybryant@ggc.allscriptsdirect.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1467526723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011742",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 ASHLEY CIR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043339",
            "telephone_number": "270-781-4090",
            "fax_number": "270-842-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2931",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.