Individual provider Active NPI

Marvin Lamar Bryant Jr., MD

  • Gastroenterology Physician
  • Vancouver, WA
National Provider Identifier
1518906676
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD00044491 Issued in WA
Practice address
2525 NE 139TH St
Vancouver, WA 98686-2719
Phone
(360) 882-2778
Fax
(360) 604-1737
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD00044491 WA Primary

Addresses

Primary practice location

2525 NE 139TH St
Vancouver, WA 98686-2719

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Other identifiers 1

IdentifierTypeStateIssuer
8431322MedicaidWA

Other names 1

  • M. Lamar Bryant Jr. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050812000141 WA Practitioner - Gastroenterology 8527097294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Mississippi School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

2529 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy51
Upper gastrointestinal (GI) endoscopy for acid reflux88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00044491WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mbryant1643@tvc-direct.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1518906676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MARVIN",
        "middle_name": "LAMAR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00044491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8431322",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "BRYANT",
            "middle_name": "LAMAR",
            "suffix": "JR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.