Individual provider Active NPI

Bryla N. Simpson, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1487052379
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA09426 Issued in TX
Practice address
1303 McCullough Ave Ste 135
San Antonio, TX 78212
Phone
(210) 227-9214
Fax
(210) 476-8515
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA09426 TX Primary

Addresses

Primary practice location

1303 McCullough Ave Ste 135
San Antonio, TX 78212

Mailing address

1303 McCullough Ave. Ste 135
San Antonio, TX 78212
Phone (210) 227-9214

Other names 1

  • Bryla N. Renfro Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150519001943 TX Practitioner - Physician Assistant 6507186335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09426TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Aug 17, 2020 Accepting new patients

Locations

1303 McCullough Ave
Ste 135
San Antonio, TX 78212
Phone (210) 225-5741

98 Briggs St
Ste 800
San Antonio, TX 78224
Phone (210) 927-0884

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1487052379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE. STE 135",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-227-9214",
            "fax_number": "210-476-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 135",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-227-9214",
            "fax_number": "210-476-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "BRYLA",
        "middle_name": "N.",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYLA",
            "last_name": "RENFRO",
            "middle_name": "N.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.