NPIMap

Individual provider Active NPI

Barry Bryant

  • Pharmacist
  • La Quinta, CA
National Provider Identifier
1497116883
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
78424 Issued in CA
Practice address
44075 Jefferson St
La Quinta, CA 92253-4871
Phone
(760) 772-2969
NPI assigned
Mar 11, 2016
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S021775 AZ
Pharmacist 183500000X 78424 CA Primary

Addresses

Primary practice location

44075 Jefferson St
La Quinta, CA 92253-4871

Mailing address

44075 Jefferson St
La Quinta, CA 92253-4871
Phone (760) 772-2969

Other practice location 1

6015 E Brown Rd
Mesa, AZ 85205-4452
Phone (480) 325-5869

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL none Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S021775AZMDPharmacist
78424CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. PastSince Dec 22, 2019 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Dec 22, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1497116883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44075 JEFFERSON ST",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534871",
            "telephone_number": "760-772-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44075 JEFFERSON ST",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534871",
            "telephone_number": "760-772-2969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6015 E Brown Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852054452",
            "country_code": "US",
            "telephone_number": "480-325-5869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "BARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021775",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "78424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "44075 Jefferson St",
            "city": "LA Quinta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922534871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.