Individual provider Active NPI

Raven Bryant

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1639758782
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
104390 Issued in GA
Practice address
4301 W Markham St
Little Rock, AR 72205-7101
Phone
(501) 603-1656
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 104390 GA Primary

Addresses

Primary practice location

4301 W Markham St
Little Rock, AR 72205-7101

Mailing address

29 Liberty Heights Dr
Savannah, GA 31405-2979
Phone (912) 667-0747

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250820000329 GA Practitioner - Anesthesiology 5991105736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Georgia School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104390GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SE Georgia Anesthesia, LLC Anesthesiology CurrentSince Sep 1, 2025 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 1

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1639758782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 LIBERTY HEIGHTS DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314052979",
            "telephone_number": "912-667-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-603-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "RAVEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-08-20",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "104390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.