Individual provider Active NPI

Mary Anne Bryan, MD

  • Ophthalmology Physician
  • Big Spring, TX
National Provider Identifier
1811963507
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
K9026 Issued in TX
Practice address
300 Veterans Boulevard
West Texas VA Health Care System
Big Spring, TX 79720
Phone
(432) 263-7361
Fax
(432) 268-5044
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X K9026 TX Primary

Addresses

Primary practice location

300 Veterans Boulevard
West Texas VA Health Care System
Big Spring, TX 79720

Mailing address

300 Veterans Boulevard
West Texas VA Health Care System
Big Spring, TX 79720
Phone (432) 263-7361

Other identifiers 2

IdentifierTypeStateIssuer
09705294MedicaidMS
1556912MedicaidLA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150225000148 TX Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 0042316978

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Ophthalmology Past Accepting new patients
Associates in Ophthalmology LTD Ophthalmology Past Accepting new patients
Northwest Eye Associates Inc Ophthalmology Past Accepting new patients
Florida Clinical Practice Association Inc Past Accepting new patients

Organizations & group practices 4

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1811963507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VETERANS BOULEVARD",
            "address_2": "WEST TEXAS VA HEALTH CARE SYSTEM",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "79720",
            "telephone_number": "432-263-7361",
            "fax_number": "432-268-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VETERANS BOULEVARD",
            "address_2": "WEST TEXAS VA HEALTH CARE SYSTEM",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "79720",
            "telephone_number": "432-263-7361",
            "fax_number": "432-268-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K9026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09705294",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556912",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Spring, TX

Sources for this page

Verify at the official NPI Registry.