Individual provider Active NPI

Heather J Bryant, NP

  • Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1891776720
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0390197-23 Issued in MN
Practice address
2101 Elm St N
Fargo, ND 58102-2417
Phone
(701) 232-3241
Fax
(701) 237-2573
NPI assigned
Nov 8, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0390197-23 MN Primary

Addresses

Primary practice location

2101 Elm St N
Fargo, ND 58102-2417

Mailing address

2101 Elm St N
Fargo, ND 58102-2417
Phone (701) 232-3241

Other practice location 1

5502 W Broadway Ave
Crystal, MN 55428-3508
Phone (763) 287-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151130002033 ND Order and Referring Only - Nurse Practitioner 4789650540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0390197-23MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891776720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-232-3241",
            "fax_number": "701-237-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-232-3241",
            "fax_number": "701-237-2573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5502 W Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Crystal",
            "state": "MN",
            "postal_code": "554283508",
            "country_code": "US",
            "telephone_number": "763-287-6500",
            "fax_number": "763-287-6544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "HEATHER",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "0390197-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.