Kenneth Wayne Bryant Jr., LPC A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A15365 Issued in NC

Practice address

405 Nash St W Ste 200
Wilson, NC 27893-3761

Phone

(252) 360-1489

Fax

(252) 991-6570

NPI assigned

Jan 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1801436944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 NASH ST W STE 200",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933761",
            "telephone_number": "252-360-1489",
            "fax_number": "252-991-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NASH ST W STE 200",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933761",
            "telephone_number": "252-360-1489",
            "fax_number": "252-991-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15365",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A15365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Everit Brown, M.D.
• Jennifer Rose Bruckstein, PA-C
• Johnathan Antonio Brunson, LCAS-A
• David Allen Bryant
• Haley Bryant, RDN
• Nicole Horne Bryant
• John H Buck, MD
• Sarah Buck, COTA/L
• Bunch Love Family Care Home
• Cynthia Bunch

• Professional Counselor in Wilson, NC
• Providers in Wilson, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.