Active NPI
Joe Paul Bryan, RPH
- Pharmacist
- Kilmarnock, VA
National Provider Identifier
1619247186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202204416
- Practice address
- 573 N Main St
Kilmarnock, VA 22482-3828 - Phone
- (804) 435-8890
- NPI assigned
- Dec 30, 2011
- Last updated
- Dec 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202204416 | VA | Primary |
Addresses
Primary practice location
573 N Main St
Kilmarnock, VA 22482-3828
Mailing address
11441 Doronhurst Dr
Providence Forge, VA 23140-4436
Phone (804) 966-8150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202204416 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325203200000",
"number": "1619247186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11441 DORONHURST DR",
"city": "PROVIDENCE FORGE",
"state": "VA",
"postal_code": "231404436",
"telephone_number": "804-966-8150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "573 N MAIN ST",
"city": "KILMARNOCK",
"state": "VA",
"postal_code": "224823828",
"telephone_number": "804-435-8890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "JOE",
"middle_name": "PAUL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-30",
"last_updated": "2011-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202204416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kilmarnock, VA
- Thomas Straughan Beane Jr., RPH
- Andrew Jackson Billups III, PSYD
- Bon Secours Medical Group Richmond Specialty Care LLC (Bon Secours Orthopedic Specialists)
- Edward Vincent Bonyak, MD
- Therese Bowen, OTR/L
- James E Bryant, M.D.
- Nancy O Byrne, P.T.
- Carousel Physical Therapy, Inc. (Carousel Physical Therapy)
- Linda E. Carr-Kraft, M.A.
- Chesapeake Hospital Corporation (Bon Secours Kilmarnock Primary Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.