Jab Sports Medicine & Direct Primary Care PC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

JAB SPORTS MEDICINE & DIRECT PRIMARY CARE PC

Practice address

5521 W Lincoln Hwy Ste 230
Crown Point, IN 46307-1097

Phone

(219) 301-1158

Fax

(219) 301-1158

NPI assigned

May 16, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Joseen Bryant, MD, CAQSM, MBA

Title

Owner/President

Phone

(219) 292-4973

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1043957657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8049 W 85TH CT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078981",
            "telephone_number": "219-292-4973",
            "fax_number": "219-301-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 W LINCOLN HWY STE 230",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071097",
            "telephone_number": "219-301-1158",
            "fax_number": "219-301-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAB SPORTS MEDICINE & DIRECT PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JOSEEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "219-292-4973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, CAQSM, MBA"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Sports Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.