Randy D Bryn, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

03907R Issued in LA

Practice address

2551 Greenwood Rd
Ste 210
Shreveport, LA 71103-3905

Phone

(318) 635-0834

Fax

(318) 636-2331

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Pulmonary Disease

Education

University of Texas Medical Branch at Galveston, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK North Pulmonary and Critical CareGroup PAC ID 1759382856, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• WK North Pulmonary & Critical Care

  • Critical Care Medicine (Internal Medicine) Physician
  • Shreveport, LA
  • NPI 1265529648

  Pulmonary Disease

  Medicare reassignment Care Compare group NPD
• Bryn-Fincher Pulmonary & Critical Care

  • Pulmonary Disease Physician
  • Shreveport, LA
  • NPI 1770683997
  NPD
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1851497275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033905",
            "telephone_number": "318-635-0834",
            "fax_number": "318-636-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033905",
            "telephone_number": "318-635-0834",
            "fax_number": "318-636-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYN",
        "first_name": "RANDY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "03907R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311189",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "290003340",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Bryant, MS
• Wayne H Bryant, MASTER'S DEGREE
• Emily Elliott Bryce, PA-C
• Bryn-Fincher Pulmonary & Critical Care
• Julia Gremillion Bryn, M.A. CCC-SLP
• Blair Michelle Bryson, D.D.S.
• Gabriella Bucci
• Jamie Erin Buchanan
• Michael Buchanan, DO
• Daryl Quintin Buckelew, M.D.

• Pulmonary Disease Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pulmonary Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.