Individual provider Active NPI

Joel Corpuz Bauzon, MSN, RN, FNP-BC

  • Family Nurse Practitioner
  • Fort Irwin, CA
National Provider Identifier
1750612388
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP19460 Issued in CA
Practice address
Weed Army Community Hospital
Building 390 North Loop Road
Fort Irwin, CA 92310
Phone
(951) 760-2790
NPI assigned
Jan 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 528243 CA
Family Nurse Practitioner 363LF0000X NP19460 CA Primary

Addresses

Primary practice location

Weed Army Community Hospital
Building 390 North Loop Road
Fort Irwin, CA 92310

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (951) 760-2790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171113002036 CA Order and Referring Only - Nurse Practitioner 0042576795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
528243CAMDRegistered Nurse
19460CAMDAcupuncturist
NP19460CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1750612388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "951-760-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEED ARMY COMMUNITY HOSPITAL",
            "address_2": "BUILDING 390 NORTH LOOP ROAD",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "951-760-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUZON",
        "first_name": "JOEL",
        "middle_name": "CORPUZ",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-21",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "528243",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP19460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Irwin, CA

Sources for this page

Verify at the official NPI Registry.