Individual provider Active NPI

Russell Alan Bryant, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1780893669
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
50263 Issued in TX
Practice address
1430 Empire Central Dr
Dallas, TX 75247-4032
Phone
(214) 645-8500
Fax
(214) 648-3775
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 50263 TX
Clinical Social Worker 1041C0700X 1145 AK
Clinical Social Worker 1041C0700X 50263 TX Primary

Addresses

Primary practice location

1430 Empire Central Dr
Dallas, TX 75247-4032

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other names 1

  • Mr. Russell A. Bryant Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170629000476 TX Practitioner - Clinical Social Worker 0749559110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6363 Forest Park Rd 7TH FL
749 Univ of TX SW Med Ctr Psych
Dallas, TX 75390-9087
Phone (214) 645-8500

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1145AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Jun 5, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 13, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 13, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Jun 1, 2022 Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

1430 Empire Central Dr
Dallas, TX 75247
Phone (214) 645-8500

6363 Frst Park Rd 7th Fl
Ste 749
Dallas, TX 75390
Phone (214) 645-8500

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 7

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1780893669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 EMPIRE CENTRAL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474032",
            "telephone_number": "214-645-8500",
            "fax_number": "214-648-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "RUSSELL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "50263",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1145",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUSSELL",
            "last_name": "BRYANT",
            "middle_name": "A.",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.