Individual provider Active NPI

Kate Marie Bryan, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1578286738
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95022498 Issued in CA
Practice address
510 S Grand Ave
Glendora, CA 91741-4207
Phone
(626) 914-1980
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95022498 CA Primary

Addresses

Primary practice location

510 S Grand Ave
Glendora, CA 91741-4207

Mailing address

510 S Grand Ave
Glendora, CA 91741-4207

Other names 1

  • Miss Kate Marie MC Avoy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205000657 CA Practitioner - Nurse Practitioner 3173992732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
William Gillespie and Associates IncGroup PAC ID 7517181373, 16 clinicians

Practice addresses (Care Compare)

510 S Grand Ave
Suite 200
Glendora, CA 91741-4291
Phone (626) 914-1980

Hospital & facility affiliations

  • L a Downtown Medical Center Hospital, Los Angeles, CA, CCN 050763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95022498CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William Gillespie and Associates Inc. CurrentSince Sep 7, 2022 Accepting new patients

Locations

510 S Grand Ave
Ste 200
Glendora, CA 91741
Phone (626) 914-1980

1626 Montana Ave
Ste 645
Santa Monica, CA 90403

Organizations & group practices 1

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": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1578286738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414207",
            "telephone_number": "626-914-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KATE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "MC AVOY",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.