Active NPI
Kathryn Johnson Bryant, CTRS
- Recreation Therapist
- Tampa, FL
National Provider Identifier
1508465154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 17771
- Practice address
- 13000 Bruce B Downs Blvd # 117
Tampa, FL 33612-4745 - Phone
- (813) 610-2609
- NPI assigned
- Oct 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 17771 | FL | Primary |
Addresses
Primary practice location
13000 Bruce B Downs Blvd # 117
Tampa, FL 33612-4745
Mailing address
3804 Northridge Dr
Valrico, FL 33596-7249
Phone (813) 334-4055
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Tampa | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 17771 | FL | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1508465154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 NORTHRIDGE DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335967249",
"telephone_number": "813-334-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13000 BRUCE B DOWNS BLVD # 117",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124745",
"telephone_number": "813-610-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "KATHRYN",
"middle_name": "JOHNSON",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-23",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "FL",
"license": "17771",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Tampa",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "13000 Bruce B Downs Blvd # 117",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336124745",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.