Kelly Bryan, DT

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

4501 Hill Rd
Highland, IL 62249-3519

Phone

(618) 830-6562

Fax

(618) 503-0263

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Early Intervention Services, Inc.

  • Early Intervention Provider Agency
  • Highland, IL
  • NPI 1992244602
  NPD (past)

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1639917586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 STARLING LN",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082638",
            "telephone_number": "847-915-9850",
            "fax_number": "618-503-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 HILL RD",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622493519",
            "telephone_number": "618-830-6562",
            "fax_number": "618-503-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KELLY",
        "credential": "DT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brilliant Baby OT PLLC
• Amy Lynn Britt, CRNP
• Karla Sue Brockman, MSPT
• Shamyra Brown
• Sarah Elizabeth Broyles, PT
• Brooke Burba
• Kelly Calloway
• Martha Carmitchel, D.T.
• Hollis Carter
• Stephanie Caruso

• Developmental Therapist in Highland, IL
• Providers in Highland, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.