Individual provider Active NPI

Judy R McClary, RN, PH.D., CLNC

  • Registered Nurse
  • Chesapeake, VA
National Provider Identifier
1003044181
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001111488 Issued in VA
Practice address
140 Thrasher Rd
Chesapeake, VA 23320-4726
Phone
(757) 436-2326
Fax
(757) 410-0891
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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 0001111488 VA Primary
Pain Management Registered Nurse 163WP0000X 0001111488 VA

Addresses

Primary practice location

140 Thrasher Rd
Chesapeake, VA 23320-4726

Mailing address

140 Thrasher Rd
Chesapeake, VA 23320-4726
Phone (757) 436-2326

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)
Not enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001111488VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1003044181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 THRASHER RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204726",
            "telephone_number": "757-436-2326",
            "fax_number": "757-410-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 THRASHER RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204726",
            "telephone_number": "757-436-2326",
            "fax_number": "757-410-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLARY",
        "first_name": "JUDY",
        "middle_name": "R",
        "credential": "RN, PH.D., CLNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001111488",
            "primary": true
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "VA",
            "license": "0001111488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; 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.