Individual provider Active NPI

Joan Bryant, DO

  • Pediatrics Physician
  • Alamogordo, NM
National Provider Identifier
1508250937
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29546 Issued in NE
Practice address
2669 Scenic Dr
Alamogordo, NM 88310-8700
Phone
(575) 443-7846
NPI assigned
Mar 24, 2015
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29546 NE Primary
General Practice Physician 208D00000X 29546 NE

Addresses

Primary practice location

2669 Scenic Dr
Alamogordo, NM 88310-8700

Mailing address

2669 Scenic Dr
Alamogordo, NM 88310-8700

Other practice location 1

Brian Allgood Community Hospital
Unit 15543
Apo, AP 96205
Phone (315) 737-2875

Other practice location 2

9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-1330

Other names 1

  • Joan Choi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218000954 NM Practitioner - Pediatric Medicine 2668785676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
29546NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Feb 23, 2022 Accepting new patients
Otero County Hospital Association CurrentSince Feb 23, 2022 Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

Interoperability endpoints

  • Direct secure messaging: joan.bryant.1@6965.direct.athenahealth.com

Organizations & group practices 2

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1508250937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108700",
            "telephone_number": "575-443-7846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Brian Allgood Community Hospital",
            "address_2": "Unit 15543",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "96205",
            "country_code": "US",
            "telephone_number": "315-737-2875",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "984311000",
            "country_code": "US",
            "telephone_number": "253-968-1330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JOAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "29546",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "29546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "CHOI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alamogordo, NM

Sources for this page

Verify at the official NPI Registry.