Individual provider Active NPI

Anna Bryan, MLS

  • Student in an Organized Health Care Education/Training Program
  • Statesboro, GA
National Provider Identifier
1922732676
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1332 Southern Dr
Statesboro, GA 30460-1360
Phone
(912) 478-4636
NPI assigned
Jul 10, 2022
Last updated
Jul 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X J8E8M9S6 GA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1332 Southern Dr
Statesboro, GA 30460-1360

Mailing address

707 Park Ave NE Apt 1313
Atlanta, GA 30326-3407
Phone (478) 595-4526

Other names 1

  • Anna Whitaker Former name

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

State licenses

LicenseStateTypeSpecialty
J8E8M9S6GAMDPhlebology Physician

NPI Registry JSON

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1922732676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PARK AVE NE APT 1313",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303263407",
            "telephone_number": "478-595-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 SOUTHERN DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304601360",
            "telephone_number": "912-478-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "ANNA",
        "credential": "MLS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-10",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "GA",
            "license": "J8E8M9S6",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "WHITAKER",
            "credential": "CPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.