Jimmy Bryant, CLINICALPSYCHOLOGIST

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

455324367 Issued in PA

Practice address

1213 Vine St Ste 121
Philadelphia, PA 19107-1111

Phone

(215) 617-6510

Fax

(866) 854-7888

NPI assigned

Mar 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1699017947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 VINE ST STE 121",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071111",
            "telephone_number": "215-617-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 VINE ST STE 121",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071111",
            "telephone_number": "215-617-6510",
            "fax_number": "866-854-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JIMMY",
        "credential": "CLINICALPSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "PA",
            "license": "455324367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Bryant
• Evan Bryant, MD
• Gwendolyn J Bryant
• Janet R Bryant, CRNP
• Jewel Danella Bryant, MSN, FNP-BC
• Jonanna Rochelle Bryant, RN
• Mary Alice Bryant, CRNA
• Natasha Bryant, LCSW
• Phillip R Bryant, DO
• Robin Bryant, RN

• Community Health Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community Health Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.