Active NPI
Deborah G Bryant, PA-C
- Medical Physician Assistant
- McGrath, AK
National Provider Identifier
1699737601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 781
- Practice address
- 10 Takotna Ave
McGrath, AK 99627-9800 - Phone
- (907) 729-8624
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 10003659 | WA | |
| Medical Physician Assistant | 363AM0700X | 781 | AK | Primary |
Addresses
Primary practice location
10 Takotna Ave
McGrath, AK 99627-9800
Mailing address
4201 Tudor Centre Dr
Suite #320
Anchorage, AK 99508-5904
Phone (907) 729-8624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDA0314 | Medicaid | AK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 10003659 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcentral Foundation | Past | Accepting new patients | |
| Hope Medical Holistic Clinic PLLC | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1699737601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 TUDOR CENTRE DR",
"address_2": "SUITE #320",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085904",
"telephone_number": "907-729-8624",
"fax_number": "907-729-8607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 TAKOTNA AVE",
"city": "MCGRATH",
"state": "AK",
"postal_code": "996279800",
"telephone_number": "907-729-8624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "DEBORAH",
"middle_name": "G",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA 10003659",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AK",
"license": "781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDA0314",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in McGrath, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.