Active NPI
Elaine Marie Judy, ATC
- Specialist
- Winter Park, FL
National Provider Identifier
1003963901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AL477
- Practice address
- 2100 Summerfield Rd
Winter Park, FL 32792-5037 - Phone
- (407) 622-3217
- Fax
- (407) 622-3214
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AL477 | FL | Primary |
Addresses
Primary practice location
2100 Summerfield Rd
Winter Park, FL 32792-5037
Mailing address
808 W Winter Park St
Orlando, FL 32804-4904
Phone (407) 622-3217
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL477 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003963901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 W WINTER PARK ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328044904",
"telephone_number": "407-622-3217",
"fax_number": "407-622-3214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SUMMERFIELD RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327925037",
"telephone_number": "407-622-3217",
"fax_number": "407-622-3214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDY",
"first_name": "ELAINE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "AL477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.