Grant Matthew O'Bryan

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3405 Issued in IL

Practice address

3718 Broadway St
Quincy, IL 62305-2822

Phone

(217) 728-1505

NPI assigned

Feb 12, 2020

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1801428313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691618",
            "telephone_number": "618-624-4471",
            "fax_number": "618-624-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623052822",
            "telephone_number": "217-728-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "GRANT",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Nothold, D.C.
• Diane Nutter, NP
• Philippe Fernand Nyembo, MD
• Bonnie Brod Nytes, LCPC
• Katharine O'Brien, MA, LCPC
• Lacey Suzanne O'Connor, BS, MHP
• Julia Danielle O'Neill
• Joann O'Rourke, LCPC
• Oak Tree Counseling LLC
• Theresa H Oakley, PA-C

• All providers in Quincy, IL
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.