Elizabeth D Bryan MD PA

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

200400646 Issued in NC

Legal business name

ELIZABETH D BRYAN MD PA

Practice address

603 Beaman St Ste 402
Clinton, NC 28328-2689

Phone

(910) 592-8243

Fax

(910) 592-1552

NPI assigned

Nov 28, 2007

Last updated

Nov 28, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

April Phipps

Title

Blling Clerk

Phone

(910) 592-8243

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: admin@elizabethbryan.e-mdsdirect.com
• Direct secure messaging: elizabeth-bryan@elizabethbryan.e-mdsdirect.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Bryan, M.D., P.A.

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1346244977
  Medicare reassignment NPD

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1669654901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BEAMAN ST STE 402",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282689",
            "telephone_number": "910-592-8243",
            "fax_number": "910-592-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BEAMAN ST STE 402",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282689",
            "telephone_number": "910-592-8243",
            "fax_number": "910-592-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH D BRYAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "BLLING CLERK",
        "authorized_official_telephone_number": "910-592-8243"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NC",
            "license": "200400646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137XR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lia Kotsopoulos Ernst, M.ED. CCC-SLP
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• Sarah Ashley Ezzell, LAC
• Pamelia Elaine Faison-Davis

• Legal Medicine in Clinton, NC
• Providers in Clinton, NC by specialty
• Legal Medicine in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.