Bryan Fallis

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

BRYAN FALLIS

Practice address

4415B Aicholtz Rd Ste 200
Cincinnati, OH 45245-5135

Phone

(513) 931-0083

Fax

(859) 331-2449

NPI assigned

May 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Bryan V. Fallis, DPM

Title

Owner

Phone

(513) 931-0083

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Progressive Podiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bryan Fallis

  • Durable Medical Equipment & Medical Supplies
  • Lakeside Park, KY
  • NPI 1720314966

  9931308517

  Same PAC ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruth Ann Cooper, DPM

  • Podiatrist
  • Cincinnati, OH
  • NPI 1386640860
  NPD (past)
• Kevin C Bryant, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Traverse City, MI
  • NPI 1285949925
  NPD (past)

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1649405259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636389",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "513-931-0083",
            "fax_number": "859-331-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415B AICHOLTZ RD STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452455135",
            "telephone_number": "513-931-0083",
            "fax_number": "859-331-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN FALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "FALLIS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-931-0083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2214213",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2955422",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000619072",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Podiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Progressive Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqualin Thomas Brush, APRN
• Kari Brush, RD
• Scot Brush
• Umekia Bruton
• James M Brutz, DPT
• Bryan Fallis
• Bryan Secker
• Megan Bryan
• Traci Sue Bryan, LPN
• Allyson Kathleen Bryant

• Podiatrist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.