Organization Active NPI

Bryan Eye Clinic, P.a.

  • Ophthalmology Physician
  • Columbia, SC
National Provider Identifier
1841862224
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BRYAN EYE CLINIC, P.A.
Practice address
3600 Forest Dr Ste 201
Columbia, SC 29204-4057
Phone
(803) 888-2370
Fax
(803) 888-2371
NPI assigned
Jul 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Dr. Beau Taylor Bryan, M.D.NPI 1831414481
Title
Owner
Phone
(803) 888-2370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3600 Forest Dr Ste 201
Columbia, SC 29204-4057

Mailing address

3600 Forest Dr Ste 201
Columbia, SC 29204-4057
Phone (803) 888-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210907000694 SC Part B Supplier - Clinic/Group Practice 2860898517 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

3600 Forest Dr
Ste 201
Columbia, SC 29204
Phone (803) 888-2370

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1841862224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FOREST DR STE 201",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044057",
            "telephone_number": "803-888-2370",
            "fax_number": "803-888-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FOREST DR STE 201",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044057",
            "telephone_number": "803-888-2370",
            "fax_number": "803-888-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-888-2370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.