Individual provider Active NPI

Christopher M Bryant, D.O.

  • Internal Medicine Physician
  • Moyie Springs, ID
National Provider Identifier
1740633536
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
O-1476 Issued in ID
Practice address
7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187
Phone
(208) 304-6401
Fax
(208) 684-7115
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X O-1476 ID Primary
Pediatrics Physician 208000000X O-1476 ID

Addresses

Primary practice location

7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187

Mailing address

7820 Old Highway Two Loop
Moyie Springs, ID 83845-5187
Phone (208) 304-6401

Other practice location 1

6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone (208) 267-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220302002773 ID Practitioner - Internal Medicine 4789978446 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Boundary Community Hospital CurrentSince Feb 14, 2022 Accepting new patients
Boundary Community Hospital CurrentSince Feb 14, 2022 Accepting new patients
Boundary Community Hospital Past Accepting new patients

Locations

6640 Kaniksu St
Bonners Ferry, ID 83805
Phone (208) 267-3141

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.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1740633536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 OLD HIGHWAY TWO LOOP",
            "city": "MOYIE SPRINGS",
            "state": "ID",
            "postal_code": "838455187",
            "telephone_number": "208-304-6401",
            "fax_number": "208-684-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 OLD HIGHWAY TWO LOOP",
            "city": "MOYIE SPRINGS",
            "state": "ID",
            "postal_code": "838455187",
            "telephone_number": "208-304-6401",
            "fax_number": "208-684-7115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6640 Kaniksu St",
            "address_purpose": "LOCATION",
            "city": "Bonners Ferry",
            "state": "ID",
            "postal_code": "838057532",
            "country_code": "US",
            "telephone_number": "208-267-3141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O-1476",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "O-1476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moyie Springs, ID

Sources for this page

Verify at the official NPI Registry.