Individual provider Active NPI

Joanna A.S. Brightwater, CNP

  • Adult Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1689947038
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP02152 Issued in NM
Practice address
303 San Mateo Blvd NE Ste 104
Albuquerque, NM 87108-1382
Phone
(505) 808-2870
NPI assigned
Feb 15, 2012
Last updated
May 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X CNP02152 NM Primary
Adult Health Nurse Practitioner 363LA2200X RN77315 NM
Adult Health Nurse Practitioner 363LA2200X CNP-02152 NM
Gerontology Nurse Practitioner 363LG0600X CNP-02152 NM

Addresses

Primary practice location

303 San Mateo Blvd NE Ste 104
Albuquerque, NM 87108-1382

Mailing address

303 San Mateo Blvd NE Ste 104
Albuquerque, NM 87108-1382
Phone (505) 808-2870

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP02152NMMDAdult Health Nurse Practitioner
RN77315NMMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bosque Trails Hospice LLC CurrentSince May 11, 2025 Accepting new patients

Locations

303 San Mateo Blvd NE
#104
Albuquerque, NM 87108
Phone (505) 205-8018

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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1689947038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SAN MATEO BLVD NE STE 104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081382",
            "telephone_number": "505-808-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SAN MATEO BLVD NE STE 104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081382",
            "telephone_number": "505-808-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHTWATER",
        "first_name": "JOANNA",
        "middle_name": "A.S.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP02152",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "RN77315",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP-02152",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "CNP-02152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.