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BRYANT DOUGLAS VICKERS DO
NPI 1124812847
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Active since April 07, 2025PECOS Enrolled
1439 JESSE JEWELL PKWY NE # 202, GAINESVILLE, GA 30501(770) 219-9675 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bryant Douglas Vickers Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYANT DOUGLAS VICKERS DO (NPI 1124812847) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124812847
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRYANT DOUGLAS VICKERSCredential: DO
Location Address1439 JESSE JEWELL PKWY NE # 202Gainesville, GA 30501-3806
Mailing Address743 Spring St Ne # 710Gainesville, GA 30501-3715 · (770) 219-8730
Phone(770) 219-9675
Sole ProprietorNo
Enumeration DateApril 7, 2025
NPPES CertifiedApril 7, 2025
✔ NPI 1124812847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1439 JESSE JEWELL PKWY NE # 202, Gainesville, GA 30501
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bryant Douglas Vickers Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COLLIN MORRIS
Student in an Organized Health Care Education/Training Program
1439 JESSE JEWELL PKWY NE # 202
GAINESVILLE, GA 30501
Hall County (770) 219-9000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryant Vickers's NPI number?

The NPI number for Bryant Vickers is 1124812847. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Where is Bryant Vickers located?

Bryant Vickers practices at 1439 Jesse Jewell Pkwy NE # 202, Gainesville, GA 30501. The listed phone number is (770) 219-9675.

What is Bryant Vickers's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bryant Vickers enrolled in Medicare?

Yes. Bryant Vickers is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bryant Vickers was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.