Robert Eric Bryan, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

022122 Issued in 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

Last updated

Sep 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in GA

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

Specialty

Addiction MedicineAlso: General Practice

Education

University of Mississippi School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SGMP Southland LLC

  • Psychiatry Physician
  • Valdosta, GA
  • NPI 1447695085
  Medicare reassignment Care Compare group NPD
• HHC St. Simons Inc

  dba Focus By the Sea

  • Psychiatric Hospital
  • St Simons Island, GA
  • NPI 1972557916
  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD
• Barbara Davanzo, M.D., P.C.

  • Specialist
  • St Simons Island, GA
  • NPI 1164403234
  NPD (past)
• Pineland Area Community Services Board

  dba Pineland BHDD CSB

  • Community/Behavioral Health Agency
  • Statesboro, GA
  • NPI 1588735252
  NPD (past)
• William J. Davanzo, M.D., P.C.

  • Specialist
  • Albany, GA
  • NPI 1639150790
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1609090141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21709",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315220809",
            "telephone_number": "912-634-7714",
            "fax_number": "912-634-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 FOLLINS LN",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224263",
            "telephone_number": "912-634-7714",
            "fax_number": "912-634-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "ROBERT",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "022122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Suzanne Brock, PA
• Austin Nicholas Brown, DDS
• Joshua D Brown, PHARMD
• Lori Marie Brown
• Jonathan Hunter Browning, DPT
• Thomas Edward Bryan III, DMD
• Keely Bunkley, PHARMD
• Jill Elizabeth Burger, CCC-SLP
• Brittney Butler
• By the Sea Physician Practice LLC (St. Simons-by-the-Sea)

• Addiction Medicine (Family Medicine) Physician in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Addiction Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.