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Deactivated NPI 1528316072 Deactivated / Inactive NPI Male Practitioner

Willie D Bryant , LPN

Licensed Practical Nurse • Buffalo, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Willie Bryant has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 15, 2012
NPI Deactivation Date July 26, 2023
Total Practice Duration ~11 Years of Practice (2012 – 2023)

Professional Overview & Biography Verified Profile Summary

Willie Bryant, LPN was a registered Licensed Practical Nurse practicing in Buffalo, NY. Throughout an active medical career spanning 11 years, Willie Bryant provided care at the practice location at 210 LISBON AVE until profile deactivation on 2023-07-26.

Practice Location & Contact Primary Location

Practice Address

210 Lisbon Ave
Lower Apartment

Buffalo, NY 142151028

Telephone 7169039864

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Buffalo, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
636 Specialists

Practicing in Buffalo, NY (23738 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NY 279264

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 26, 2023

Record deactivated on July 26, 2023

NPI Profile Active September 26, 2012

NPI status registered as active in NPPES database

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Updated Practice Location September 26, 2012

Registered at 210 LISBON AVE, LOWER APARTMENT, BUFFALO, NY 142151028 (Tel: 7169039864)

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Updated Business Mailing Address September 26, 2012

Registered at 210 LISBON AVE, LOWER APARTMENT, BUFFALO, NY 142151028 (Tel: 7169039864)

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Provider Name / Credentials Updated September 26, 2012

Recorded as WILLIE BRYANT, LPN

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 26, 2012

Licensed Practical Nurse (License #279264 in NY)

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Initial NPI Registration & Enumeration August 15, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1528316072
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2012
Last Update: September 26, 2012
Deactivation Date: July 26, 2023

Mailing Address

210 Lisbon Ave, Lower Apartment

Buffalo, NY 142151028

Phone: 7169039864

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.