Active NPI
Judy Wu Dominick, PA-C
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1013064427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6137
- Practice address
- 2651 Redding Rd NE
Atlanta, GA 30319-2963 - Phone
- (404) 841-5466
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02684 | TX | |
| Physician Assistant | 363A00000X | 6137 | GA | Primary |
Addresses
Primary practice location
2651 Redding Rd NE
Atlanta, GA 30319-2963
Mailing address
2651 Redding Rd NE
Atlanta, GA 30319-2963
Phone (404) 841-5466
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87N556 | Other | TX | BLUE CROSS |
| 970013327 | Other | TX | RAILROAD MEDICARE |
Other names 1
- Miss Judy Shauchin Wu
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6137 | GA | MD | Physician Assistant |
| PA02684 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1013064427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2651 REDDING RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303192963",
"telephone_number": "404-841-5466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2651 REDDING RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303192963",
"telephone_number": "404-841-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINICK",
"first_name": "JUDY",
"middle_name": "WU",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02684",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "6137",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "87N556",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970013327",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JUDY",
"last_name": "WU",
"middle_name": "SHAUCHIN",
"prefix": "MISS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.