Marissa Bryant, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA21622 Issued in FL

Practice address

10061 Sweetwater Pkwy
Jacksonville, FL 32256-3977

Phone

(904) 519-1034

NPI assigned

Oct 10, 2022

Sex

Female

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

State licenses

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1558086835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 BLUE WING CT",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10061 SWEETWATER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563977",
            "telephone_number": "904-519-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MARISSA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA21622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Calvin Coolidge Bryant, MD
• Karen Voncille Bryant, PA-C
• Katelyn Lee Bryant, APRN
• Laurie Susan Bryant, D.O.
• Lynsey Bryant
• Mikel Bryant, RDN
• Monechia Bryant
• Tamesha Bryant, RN
• Vaughn Everett Bryant, PHD
• Bryants Bloomers Inc

• Physical Therapy Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.