Robert Eric Bryan, MD
Individual provider Active NPI Addiction Medicine (Family Medicine) Physician · Saint Simons Island, GA
NPI 1609090141 · NPPES record last updated Sep 20, 2016
Key facts
- NPI
- 1609090141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Family Medicine) Physician 207QA0401X
- License
- 022122 (GA)
- Practice address
- 143 Follins LN
Saint Simons Island, GA 31522-4263 - Phone
- (912) 634-7714
- Fax
- (912) 634-7734
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Addiction Medicine
- Education
- University of Mississippi School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SGMP Southland, LLC
Practice addresses (Care Compare)
2927 Demere Rd
St Simons Is, GA 31522-1620
Phone (229) 236-0831
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080131000300 | GA | Practitioner - Addiction Medicine |
0840241832 |
Reassigns benefits to 2 organizations Practice locations: Brunswick, GA; Saint Marys, GA |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SGMP Southland LLC | Current |
Accepting new patients | |
| Choice Family Medicine, PC | Current | Accepting new patients | |
| HHC St. Simons Inc | Current |
Accepting new patients | |
| Pineland Area Community Services Board | Past |
Accepting new patients | |
| Barbara Davanzo, M.D., P.C. | Past | Accepting new patients | |
| William J. Davanzo, M.D., P.C. | Past | Accepting new patients |
Locations
2927 Demere Rd
St Simons Island, GA 31522
Phone (912) 638-1999
201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 022122 | GA | Yes |
Addresses
Primary practice location
143 Follins LN
Saint Simons Island, GA 31522-4263
Mailing address
PO Box 21709
Saint Simons Island, GA 31522-0809
Phone (912) 634-7714
Other providers in Saint Simons Island, GA
- Heather Suzanne Brock
- Austin Nicholas Brown
- Joshua D Brown
- Lori Marie Brown
- Jonathan Hunter Browning
- Thomas Edward Bryan III
- Keely Bunkley
- Jill Elizabeth Burger
- Brittney Butler
- By the Sea Physician Practice LLC
All providers in Saint Simons Island, GA · Addiction Medicine (Family Medicine) Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.