Individual provider Active NPI

Joann McCullar Vandergriff, MSN, FNP

  • Family Nurse Practitioner
  • Carlsbad, NM
National Provider Identifier
1891772885
Registry record updated Jul 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R35927 Issued in NM
Practice address
2430 W Pierce St
Carlsbad, NM 88220-3553
Phone
(505) 887-4100
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R35927 NM Primary

Addresses

Primary practice location

2430 W Pierce St
Carlsbad, NM 88220-3553

Mailing address

PO Box 1382
Carlsbad, NM 88221-1382
Phone (505) 887-4073

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, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R35927NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lea Emergency Group LLC Past Accepting new patients
Quantum Healthcare Medical Associates Inc. Past Accepting new patients
Eddy Emergency Group LLC Past Accepting new patients
Artesia General Hospital Past Accepting new patients

Organizations & group practices 4

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185580800000",
    "number": "1891772885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1382",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882211382",
            "telephone_number": "505-887-4073",
            "fax_number": "505-887-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203553",
            "telephone_number": "505-887-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFF",
        "first_name": "JOANN",
        "middle_name": "MCCULLAR",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2007-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R35927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2007; 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.