Individual provider Active NPI

Mary Harrell Bryan, SLP

  • Speech-Language Pathologist
  • Tuscaloosa, AL
National Provider Identifier
1629464391
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3733 Issued in AL
Practice address
700 University Blvd E
Tuscaloosa, AL 35401-2028
Phone
(205) 348-7131
Fax
(205) 348-1845
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3733 AL Primary

Addresses

Primary practice location

700 University Blvd E
Tuscaloosa, AL 35401-2028

Mailing address

PO Box 870242
Tuscaloosa, AL 35487-0242
Phone (205) 348-7131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220812000554 AL Practitioner - Qualified Speech Language Pathologist 8729461405 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Alabama Speech-Language Pathologist CurrentSince Aug 1, 2022 Accepting new patients
The Board of Trustees of the University of Alabama Past Accepting new patients

Locations

700 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 348-7131

870242 Box
Tuscaloosa, AL 35487

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1629464391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870242",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354870242",
            "telephone_number": "205-348-7131",
            "fax_number": "205-348-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012028",
            "telephone_number": "205-348-7131",
            "fax_number": "205-348-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "MARY",
        "middle_name": "HARRELL",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "3733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.