Robert Ray Bryant, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

204 W Hill Blvd
Charleston AFB, SC 29404-4704

Phone

(843) 963-6790

NPI assigned

Sep 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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)

Not enrolled

Credentials

Physician Assistant

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.

• United States Air Force

  • Clinic/Center
  • Charleston AFB, SC
  • NPI 1023246659
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487756839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 KYLE CT",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858034",
            "telephone_number": "843-993-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "ROBERT",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 628TH Medgrp-Charleston
• George James Antolick, IDMT
• Karen Berkeley, PHARMD
• Shannon L Bolen, MSW
• James Edwin Boyd, M.D.
• Michelle Karen Calandra, RN
• Douglas Vail Campbell, PSY.D.
• Naihla Carr
• Karina Cortes, IDMT
• Jennifer B Cutlip, IDMT

• Physician Assistant in Charleston AFB, SC
• Providers in Charleston AFB, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.