Individual provider Active NPI

Mary Kathryn Bryant

  • Social Worker
  • Tullahoma, TN
National Provider Identifier
1679121222
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1803 N Jackson St
Tullahoma, TN 37388-2201
Phone
(931) 461-1300
NPI assigned
Aug 27, 2019
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1803 N Jackson St
Tullahoma, TN 37388-2201

Mailing address

1803 N Jackson St
Tullahoma, TN 37388-2201
Phone (931) 461-1300

Other practice location 1

604 S Wall St
Shelbyville, TN 37160-3797
Phone (931) 684-0522 ext. 93146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Dec 10, 2018 Accepting new patients
Centerstone of Tennessee, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

604 S Wall St
Shelbyville, TN 37160
Phone (931) 684-0522

1803 N Jackson St
Tullahoma, TN 37388
Phone (931) 461-1300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1679121222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882201",
            "telephone_number": "931-461-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882201",
            "telephone_number": "931-461-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 S Wall St",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "TN",
            "postal_code": "371603797",
            "country_code": "US",
            "telephone_number": "931-684-0522 x93146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.