Active NPI
Bernard O Judy, MD
- Internal Medicine Physician
- Kansas City, MO
National Provider Identifier
1023009933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35687
- Practice address
- 373 W 101St Ter
Kansas City, MO 64114 - Phone
- (816) 942-8200
- Fax
- (913) 495-3760
- NPI assigned
- Oct 31, 2005
- Last updated
- Jul 9, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04-18615 | KS | |
| Internal Medicine Physician | 207R00000X | 35687 | MO | Primary |
Addresses
Primary practice location
373 W 101St Ter
Kansas City, MO 64114
Mailing address
8550 Marshall Dr Ste 220
Lenexa, KS 66214-1505
Phone (913) 495-2208
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201260916 | Medicaid | MO | |
| 200305490 | Medicaid | KS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-18615 | KS | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1023009933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8550 MARSHALL DR STE 220",
"city": "LENEXA",
"state": "KS",
"postal_code": "662141505",
"telephone_number": "913-495-2208",
"fax_number": "913-273-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "373 W 101ST TER",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64114",
"telephone_number": "816-942-8200",
"fax_number": "913-495-3760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDY",
"first_name": "BERNARD",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "04-18615",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "35687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201260916",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200305490",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.