Active NPI
Jennifer M O'Bryan, MD
- Pediatrics Physician
- Southaven, MS
National Provider Identifier
1689662702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD19112
- Practice address
- 5960 Getwell Rd Ste 102-103
Southaven, MS 38672-7318 - Phone
- (662) 443-4408
- Fax
- (901) 214-6249
- NPI assigned
- Oct 12, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD19112 | MS | Primary |
| Pediatrics Physician | 208000000X | MD39982 | TN |
Addresses
Primary practice location
5960 Getwell Rd Ste 102-103
Southaven, MS 38672-7318
Mailing address
5960 Getwell Rd Ste 102-103
Southaven, MS 38672-7318
Phone (662) 443-4408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5440602 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19112 | MS | MD | Pediatrics Physician |
| MD39982 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventure Pediatrics, PLLC | Pediatrics | Current | Accepting new patients |
| Memphis Children'S Clinic, PLLC | Pediatrics | Past | Accepting new patients |
| Methodist Healthcare - Memphis Hospitals | Past | Accepting new patients | |
| Memphis Children'S Clinic, PLLC | Pediatrics | Past | Accepting new patients |
| Memphis Children'S Clinic,PLLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jobryan@linux.pcc-direct.com
- jobryan27646@mlh.direct-ci.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Southaven, MS
- NPI 1659225886
-
- Pediatrics Physician
- Southaven, MS
- NPI 1790865616
-
- Pediatrics Physician
- Olive Branch, MS
- NPI 1649450909
-
- Pediatrics Physician
- Bartlett, TN
- NPI 1477633303
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771891200000",
"number": "1689662702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5960 GETWELL RD STE 102-103",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386727318",
"telephone_number": "662-443-4408",
"fax_number": "901-214-6249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5960 GETWELL RD STE 102-103",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386727318",
"telephone_number": "662-443-4408",
"fax_number": "901-214-6249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRYAN",
"first_name": "JENNIFER",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-12",
"last_updated": "2026-02-24",
"certification_date": "2026-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "MD19112",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "MD39982",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5440602",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.