Individual provider Active NPI

Ashley Nicole Bryant, CPNP-PC

  • Pediatric Nurse Practitioner
  • Stone Mountain, GA
National Provider Identifier
1679293260
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NCO-000006 Issued in GA
Practice address
5674 Memorial Dr
Stone Mountain, GA 30083-3254
Phone
(770) 322-6161
NPI assigned
Sep 1, 2022
Last updated
Jan 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NCO-000006 GA Primary

Addresses

Primary practice location

5674 Memorial Dr
Stone Mountain, GA 30083-3254

Mailing address

5674 Memorial Dr
Stone Mountain, GA 30083-3254
Phone (770) 322-6161

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

State licenses

LicenseStateTypeSpecialty
NCO-000006GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Atlanta Pediatrics PC Single Specialty CurrentSince Jan 29, 2023 Accepting new patients
Grayson Pediatrics, LLC Single Specialty PastSince Sep 1, 2022 Accepting new patients
Gim Enterprises LLC Single Specialty Past Accepting new patients
Grayson Pediatrics, LLC Single Specialty PastSince Apr 21, 2024 Accepting new patients

Locations

5674 Memorial Dr
Stone Mountain, GA 30083
Phone (770) 322-6161

Organizations & group practices 4

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1679293260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5674 MEMORIAL DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833254",
            "telephone_number": "770-322-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5674 MEMORIAL DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833254",
            "telephone_number": "770-322-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "NCO-000006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.