Organization Active NPI

Joy M Deshazo MD LLC

  • Physical Medicine & Rehabilitation Physician
  • Huntsville, AL
National Provider Identifier
1508533852
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
JOY M DESHAZO MD LLC
Practice address
1490 Highway 72 E
Huntsville, AL 35811-1508
Phone
(256) 651-3910
NPI assigned
Aug 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Joy M Deshazo, MD
Title
Owner
Phone
(256) 651-3910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1490 Highway 72 E
Huntsville, AL 35811-1508

Mailing address

PO Box 796
Huntsville, AL 35804-0796
Phone (256) 651-3910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210923002429 AL Part B Supplier - Clinic/Group Practice 0648677294 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1508533852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 796",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358040796",
            "telephone_number": "256-651-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 HIGHWAY 72 E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358111508",
            "telephone_number": "256-651-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOY M DESHAZO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "DESHAZO",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-651-3910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.