Individual provider Active NPI

Jonathan Alden Bryan, DO

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1881221141
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
87286 Issued in SC
Practice address
Grand Strand Medical Center
809 82ND Parkway
Myrtle Beach, SC 29572
Phone
(843) 692-1752
NPI assigned
Mar 26, 2020
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X SC
Emergency Medicine Physician 207P00000X 87286 SC Primary

Addresses

Primary practice location

Grand Strand Medical Center
809 82ND Parkway
Myrtle Beach, SC 29572

Mailing address

5291 Happy Hollow Rd
Dunwoody, GA 30360-1261
Phone (832) 477-4745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20221118002827 SC Practitioner - Emergency Medicine 5890111967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Oct 17, 2022 Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Oct 17, 2022 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

Interoperability endpoints

  • Direct secure messaging: jbryan25432@directmcleodehealth.org
  • Direct secure messaging: jonathan.bryan@hca5.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1881221141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5291 HAPPY HOLLOW RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303601261",
            "telephone_number": "832-477-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRAND STRAND MEDICAL CENTER",
            "address_2": "809 82ND PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-692-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "JONATHAN",
        "middle_name": "ALDEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "87286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.