Active NPI
John Allen Bryant, O. D.
- Corneal and Contact Management Optometrist
- Aurora, CO
National Provider Identifier
1801886635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 960
- Practice address
- 14991 E Hampden Ave
Suite 110
Aurora, CO 80014-3983 - Phone
- (303) 963-9561
- Fax
- (303) 963-0713
- NPI assigned
- Oct 24, 2005
- Last updated
- Dec 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 960 | CO | Primary |
Addresses
Primary practice location
14991 E Hampden Ave
Suite 110
Aurora, CO 80014-3983
Mailing address
1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594
Phone (719) 219-3819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08009607 | Medicaid | CO |
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 |
|---|---|---|---|
| 960 | CO | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ponderosa Vision Clinic, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Aurora, CO
- NPI 1275632192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1801886635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 LAKE PLAZA DR",
"address_2": "SUITE 230",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063594",
"telephone_number": "719-219-3819",
"fax_number": "719-219-0411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14991 E HAMPDEN AVE",
"address_2": "SUITE 110",
"city": "AURORA",
"state": "CO",
"postal_code": "800143983",
"telephone_number": "303-963-9561",
"fax_number": "303-963-0713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "JOHN",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "O. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CO",
"license": "960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08009607",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.