Individual provider Active NPI

Jennifer M O'Bryan, MD

  • Pediatrics Physician
  • Southaven, MS
National Provider Identifier
1689662702
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD19112 Issued in MS
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

Updated by the provider on Feb 24, 2026

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 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

IdentifierTypeStateIssuer
5440602MedicaidTN

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

LicenseStateTypeSpecialty
MD19112MSMDPediatrics Physician
MD39982TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: jobryan@linux.pcc-direct.com
  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.