Individual provider Active NPI

John P Bryant, M.D.

  • Family Medicine Physician
  • Yorktown, VA
National Provider Identifier
1952308249
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101032326 Issued in VA
Practice address
307 Cook Rd
Yorktown, VA 23690-9640
Phone
(757) 898-7261
Fax
(757) 890-0139
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101032326 VA Primary

Addresses

Primary practice location

307 Cook Rd
Yorktown, VA 23690-9640

Mailing address

860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8777

Other identifiers 3

IdentifierTypeStateIssuer
080047252OtherRAILROAD MEDICARE
096541OtherVAANTHEM
5638569MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100416000031 VA Practitioner - Family Practice 5496882805 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Apr 21, 1993 Accepting new patients
Tidewater Physicians Multispecialty Group PC Family Medicine CurrentSince Apr 21, 1993 Accepting new patients

Locations

101 York Crossing Rd
#A
Grafton, VA 23692
Phone (757) 898-7737

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

827 Diligence Dr
Ste 100
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

307 Cook Rd
Yorktown, VA 23690
Phone (757) 898-7261

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1952308249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8777",
            "fax_number": "757-232-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 COOK RD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236909640",
            "telephone_number": "757-898-7261",
            "fax_number": "757-890-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080047252",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "096541",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5638569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

Verify at the official NPI Registry.