Individual provider Active NPI

James Lee Bryant II, MD

  • Otolaryngology Physician
  • Bridgeport, WV
National Provider Identifier
1497847651
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
08691 Issued in WV
Practice address
527 Medical Park Drive
Suite 501
Bridgeport, WV 26330
Phone
(681) 342-3571
Fax
(681) 342-3575
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 08691 WV Primary

Addresses

Primary practice location

527 Medical Park Drive
Suite 501
Bridgeport, WV 26330

Mailing address

527 Medical Park Drive
Suite 501
Bridgeport, WV 26330
Phone (681) 342-3571

Other identifiers 1

IdentifierTypeStateIssuer
0101431000MedicaidWV

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
08691WVMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose and Throat Assoc of Clarksburg Inc Otolaryngology Past Accepting new patients
United Vascular & Vein Center PLLC PastSince Aug 25, 2014 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1497847651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 501",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "681-342-3571",
            "fax_number": "681-342-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 501",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "681-342-3571",
            "fax_number": "681-342-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WV",
            "license": "08691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101431000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.