Active NPI
Michael Sinclair Bryan, O.D.
- Corneal and Contact Management Optometrist
- Goldsboro, NC
National Provider Identifier
1487605408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 1113
- Practice address
- 611 N Berkeley Blvd Ste a
Goldsboro, NC 27534-3468 - Phone
- (919) 778-9662
- Fax
- (919) 778-9930
- NPI assigned
- May 15, 2006
- Last updated
- Mar 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 1113 | NC | Primary |
Addresses
Primary practice location
611 N Berkeley Blvd Ste a
Goldsboro, NC 27534-3468
Mailing address
5959 Triangle Town Blvd
Suite 2001
Raleigh, NC 27616-3268
Phone (919) 792-2345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89-09494 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1113 | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Eye Care Group | Past | Accepting new patients | |
| Clark Optometric Center PA | Past | Accepting new patients | |
| Weitzel & Associates PA | Past | Accepting new patients | |
| Contact Lens Institute, Optometry, PA | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Optometrist
- Raleigh, NC
- NPI 1851480347
-
- Optometrist
- Greensboro, NC
- NPI 1215994371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332374400000",
"number": "1487605408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 TRIANGLE TOWN BLVD",
"address_2": "SUITE 2001",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276163268",
"telephone_number": "919-792-2345",
"fax_number": "919-792-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 N BERKELEY BLVD STE A",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275343468",
"telephone_number": "919-778-9662",
"fax_number": "919-778-9930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "MICHAEL",
"middle_name": "SINCLAIR",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2012-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NC",
"license": "1113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89-09494",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.