NPIMap

Individual provider Active NPI

Cary John Judy, D.O.

  • Family Medicine Physician
  • Gunnison, UT
National Provider Identifier
1013078344
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51726651204 Issued in UT
Practice address
95 E Center
Gunnison, UT 84634
Phone
(435) 528-7227
Fax
(435) 528-2175
NPI assigned
Dec 12, 2006
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51726651204 UT Primary

Addresses

Primary practice location

95 E Center
Gunnison, UT 84634

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920000006 UT Practitioner - Family Practice 2466420351 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305
Phone (801) 429-8000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions35
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
51726651204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Feb 1, 2013 Accepting new patients
Revere Health PC CurrentSince Feb 1, 2013 Accepting new patients
Gunnison Valley Hospital CurrentSince Aug 31, 2009 Accepting new patients

Locations

191 S Main St
Ste 1
Ephraim, UT 84627
Phone (801) 655-5490

568 S Main St
Monroe, UT 84754
Phone (435) 527-8866

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

Interoperability endpoints

  • Direct secure messaging: caryjudy@cuccu.allscriptsdirect.net
  • FHIR API: https://fhir-usa.unify.chbase.com/org/gunniso-89e20968

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1013078344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E CENTER",
            "city": "GUNNISON",
            "state": "UT",
            "postal_code": "84634",
            "telephone_number": "435-528-7227",
            "fax_number": "435-528-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDY",
        "first_name": "CARY",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "51726651204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "N",
            "address_1": "95 E Center",
            "city": "Gunnison",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gunnison, UT

Sources for this page

Verify at the official NPI Registry.