Individual provider Active NPI

Daniel J Judge, D.C.

  • Chiropractor
  • Birmingham, MI
National Provider Identifier
1003828047
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009205 Issued in MI
Practice address
725 S Adams Rd
Suite 198
Birmingham, MI 48009-6902
Phone
(248) 885-3866
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034638 WA
Chiropractor 111N00000X 2301009205 MI Primary

Addresses

Primary practice location

725 S Adams Rd
Suite 198
Birmingham, MI 48009-6902

Mailing address

1513 Beaufield St
Ferndale, MI 48220-1612
Phone (248) 885-3866

Other identifiers 1

IdentifierTypeStateIssuer
0211795OtherWADEPT LABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000113 MI Practitioner - Chiropractic 6406852235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Life, PLLCGroup PAC ID 1153515432, 2 clinicians

Practice addresses (Care Compare)

3400 Rochester Rd
Royal Oak, MI 48073-2813
Phone (248) 593-0843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009205MIMDChiropractor
CH00034638WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Life, PLLC Chiropractor CurrentSince Aug 4, 2010 Accepting new patients
Health First Chiropractic Inc. PS Chiropractor Past Accepting new patients
Health First Chiropractic Inc PS Chiropractor Past Accepting new patients

Locations

725 S Adams Rd
Ste 198
Birmingham, MI 48009
Phone (248) 593-0843

3400 Rochester Rd
Royal Oak, MI 48073
Phone (248) 593-0843

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1003828047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 BEAUFIELD ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201612",
            "telephone_number": "248-885-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ADAMS RD",
            "address_2": "SUITE 198",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096902",
            "telephone_number": "248-885-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034638",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT LABOR & INDUSTRIES",
            "identifier": "0211795",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.