Individual provider Active NPI

James W Bryer, L.P.

  • Counseling Psychologist
  • Waite Park, MN
National Provider Identifier
1972521052
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP1020 Issued in MN
Practice address
110 2ND St S
Ste 301
Waite Park, MN 56387-1314
Phone
(320) 252-2976
Fax
(320) 656-1570
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP1020 MN Primary

Addresses

Primary practice location

110 2ND St S
Ste 301
Waite Park, MN 56387-1314

Mailing address

110 2ND St S
Ste 301
Waite Park, MN 56387-1314
Phone (320) 252-2976

Other identifiers 1

IdentifierTypeStateIssuer
516247500MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050325000333 MN Practitioner - Clinical Psychologist 7012962855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ohio State University College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Processus P.a.Group PAC ID 2860447604, 9 clinicians

Practice addresses (Care Compare)

110 2ND S St
Suite 301
Waite Park, MN 56387-1314
Phone (320) 252-2976

110 2ND St S
Suite 301
Waite Park, MN 56387-1314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP1020MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Processus P.a. Counseling CurrentSince Oct 1, 1991 Accepting new patients

Locations

110 2nd St S
Ste 301
Waite Park, MN 56387
Phone (320) 240-9595

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1972521052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 2ND ST S",
            "address_2": "STE 301",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871314",
            "telephone_number": "320-252-2976",
            "fax_number": "320-656-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST S",
            "address_2": "STE 301",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871314",
            "telephone_number": "320-252-2976",
            "fax_number": "320-656-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYER",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "516247500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

Verify at the official NPI Registry.