Stacie L. Bryant, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22003399A Issued in IN

Practice address

603 Port Drive
Avon, IN 46123-4612

Phone

(317) 272-8238

NPI assigned

Oct 29, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Stacie L. Bryant Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Illinois LLCGroup PAC ID 2365718277, 361 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Empowerme Rehabilitation Illinois, LLC

  • Multi-Specialty Clinic/Center
  • Kokomo, IN
  • NPI 1023618956

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation Illinois, LLC

  • Rehabilitation Clinic/Center
  • Mount Carmel, IL
  • NPI 1962073734

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1982930780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 PORT DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461231239",
            "telephone_number": "317-272-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 PORT DRIVE",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461234612",
            "telephone_number": "317-272-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "STACIE",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003399A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "BRYANT",
            "middle_name": "L.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rylie Brown, RBT
• Erin Browne, RBT
• Dustin Broyles, DDS
• Tanalee Dawn Bruce
• Amelia S Bruner, RN
• Michael D Buckwalter, MD
• Sara Budd
• Natalie Bullock
• Katherine Blair Bumgardner, DMD, MSD
• Richard Douglas Burdick, O.D.

• Speech-Language Pathologist in Avon, IN
• Providers in Avon, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.