Individual provider Active NPI

Kevin Michael Bryant, APRN

  • Family Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1689406357
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015653A Issued in IN
Practice address
200 Alfred St
Michigan City, IN 46360-7303
Phone
(219) 872-6200
NPI assigned
Aug 20, 2024
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015653A IN Primary

Addresses

Primary practice location

200 Alfred St
Michigan City, IN 46360-7303

Mailing address

26 Kincraig Dr
Valparaiso, IN 46385-9290
Phone (219) 405-9302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241017002727 IN Practitioner - Nurse Practitioner 5698207462 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians

Practice addresses (Care Compare)

31 E Sibley St
Suite a
Hammond, IN 46320-1725
Phone (219) 802-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71015653AINMDFamily Nurse Practitioner

Organizations & group practices 3

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1689406357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 KINCRAIG DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463859290",
            "telephone_number": "219-405-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALFRED ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607303",
            "telephone_number": "219-872-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015653A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.