Active NPI
Carson Bryan, JD, PRSS
- Peer Specialist
- Saint Albans, WV
National Provider Identifier
1841944402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 21-971
- Practice address
- 2333 Maccorkle Ave
Saint Albans, WV 25177-2073 - Phone
- (681) 205-8548
- Fax
- (855) 888-9316
- NPI assigned
- Feb 11, 2022
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 21-971 | WV | Primary |
Addresses
Primary practice location
2333 Maccorkle Ave
Saint Albans, WV 25177-2073
Mailing address
2333 Maccorkle Ave
Saint Albans, WV 25177-2073
Phone (681) 205-8548
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | carsonbryan@anchorprojectcenter.org | Direct |
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)
- Not enrolled
- Credentials
- Juris Doctor
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-971 | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1841944402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2333 MACCORKLE AVE",
"city": "SAINT ALBANS",
"state": "WV",
"postal_code": "251772073",
"telephone_number": "681-205-8548",
"fax_number": "855-888-9316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 MACCORKLE AVE",
"city": "SAINT ALBANS",
"state": "WV",
"postal_code": "251772073",
"telephone_number": "681-205-8548",
"fax_number": "855-888-9316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "CARSON",
"credential": "JD, PRSS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-11",
"last_updated": "2022-02-11",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "21-971",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "carsonbryan@anchorprojectcenter.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2333 MacCorkle Ave",
"city": "Saint Albans",
"state": "WV",
"country_code": "US",
"postal_code": "251772073",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Albans, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.