Joel David Drallette, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101022144 Issued in MI

Practice address

4175 S. Alamo Ave
Davis Monthan Afb, AZ 85750

Phone

(520) 228-1920

NPI assigned

May 27, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1861804791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "85750",
            "telephone_number": "520-228-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S. ALAMO AVE",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "85750",
            "telephone_number": "520-228-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRALLETTE",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "MI",
            "license": "5101022144",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Myungsoo Chung, DDS
• Jayme L Cline, IDMT
• Amanda Cook, DO
• Jason West Cromar, M.D., M.P.H.
• Angela C. Demaio, LCSW, LISAC
• Mary Anne Eisma
• Cameron John Elward, MD
• Ciera Domonique Paige Espinosa, PHARMD
• Denise Fabian, M.D.
• Christopher Guerrero, LCSW

• Family Medicine Physician in Davis Monthan Afb, AZ
• Providers in Davis Monthan Afb, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.