NPIMap

Individual provider Active NPI

Wesley Nathan Bryson, MD

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1609255546
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
53575 Issued in KY
Practice address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone
(502) 447-8786
Fax
(502) 447-8623
NPI assigned
May 26, 2015
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2017044554 MO
Diagnostic Radiology Physician 2085R0202X 53575 KY Primary

Addresses

Primary practice location

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Mailing address

9152 Taylorsville Rd # 276
Louisville, KY 40299-1752
Phone (502) 447-8786

Other identifiers 2

IdentifierTypeStateIssuer
7100730580MedicaidKY
300050686MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KY, IN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200518001030 MO Practitioner - Diagnostic Radiology 0547691024 Reassigns benefits to 2 organizations
I20210506001591 KY Practitioner - Diagnostic RadiologyPractitioner - Interventional Pain Management 0547691024 Reassigns benefits to 1 organization
I20240322000549 IN Practitioner - Diagnostic Radiology 0547691024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic X-Ray Physicians, PSCGroup PAC ID 1355239534, 36 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (502) 447-8786

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
91.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53575KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince Jun 15, 2020 Accepting new patients
Diagnostic X-Ray Physicians, PSC Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jun 15, 2020 Accepting new patients

Locations

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

157 Towne Dr
Ste 101
Elizabethtown, KY 42701
Phone (270) 740-5201

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

3991 Dutchmans Ln
Ste 208
Louisville, KY 40207
Phone (502) 897-2440

5129 Dixie Hwy
Ste 100
Louisville, KY 40216
Phone (502) 447-3242

9152 Taylorsville Rd
Louisville, KY 40299
Phone (502) 424-5635

9344 Cedar Center Way
Louisville, KY 40291
Phone (502) 753-3390

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

Organizations & group practices 3

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1609255546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9152 TAYLORSVILLE RD # 276",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991752",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "WESLEY",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2024-01-04",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2017044554",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "53575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100730580",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300050686",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.