Coleman J Bryan Jr., M.D., MSPH

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

0101254561 Issued in VA

Practice address

554 Keily Street
Jacksonville, FL 32212

Phone

(757) 953-7550

Fax

(757) 953-7560

NPI assigned

Oct 23, 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

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

Specialty

Hematology/OncologyAlso: Pediatric Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

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.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment Care Compare group NPD
• The Children'S Hospital of Alabama

  • Pediatrics Physician
  • Hueytown, AL
  • NPI 1104903749
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1962585968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 KEILY STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "757-953-7550",
            "fax_number": "757-953-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 KEILY STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "757-953-7550",
            "fax_number": "757-953-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "COLEMAN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "M.D., MSPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "VA",
            "license": "0101254561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009994025",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009993995",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juanita Claudian Bruno, LMFT
• Thomas James Bruno
• Christopher Brunson, CAP 5938
• Brushes and Brackets Dental Studio
• Betty Regina Bryan
• David Michael Bryan, PHARM.D.
• Elizabeth Jo Bryan
• Grace Bryan, PAC
• Makayla Ashley Bryan
• Yatae Keneshia Bryant Bell

• Pediatric Hematology & Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.