Individual provider Active NPI

Justin John Joseph, DO

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1679070502
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S9910 Issued in TX
Practice address
2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804
Phone
(361) 861-1861
NPI assigned
Apr 8, 2018
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S9910 TX Primary

Addresses

Primary practice location

2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

1111 Augusta Dr
Houston, TX 77057-2209
Phone (713) 442-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210621000595 TX Practitioner - Family Practice 0547517690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

1111 Augusta Dr
Houston, TX 77057-2209
Phone (713) 442-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S9910TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Family Medicine CurrentSince Aug 9, 2021 Accepting new patients

Locations

1111 Augusta Dr
Houston, TX 77057
Phone (713) 442-2400

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

6401 Woodway Dr
Ste 149
Houston, TX 77057
Phone (713) 442-2400

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Organizations & group practices 1

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": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1679070502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD STE B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051804",
            "telephone_number": "361-861-1861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Augusta Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770572209",
            "country_code": "US",
            "telephone_number": "713-442-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-08",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S9910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.