Individual provider Active NPI

Judd Paul Davis, DC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1174520266
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13154 Issued in FL
Practice address
7335 W Sand Lake Rd Ste 125
Orlando, FL 32819-5539
Phone
(497) 930-7132
NPI assigned
Jul 5, 2005
Reactivated
Jun 12, 2007
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13154 FL Primary

Addresses

Primary practice location

7335 W Sand Lake Rd Ste 125
Orlando, FL 32819-5539

Mailing address

1675 S Fiske Blvd Apt M153
Rockledge, FL 32955-2573
Phone (914) 821-7393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220329002467 FL Practitioner - Chiropractic 1759489685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next Medical Florida LLCGroup PAC ID 1355570474, 16 clinicians

Practice addresses (Care Compare)

1770 S Woodland Blvd
Deland, FL 32720-7915
Phone (407) 889-3223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13154FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Next Medical Florida LLC Chiropractor CurrentSince Feb 21, 2022 Accepting new patients
Green Oak Professional Health Services PastSince Aug 11, 2019 Accepting new patients

Locations

1770 S Woodland Blvd
Deland, FL 32720
Phone (386) 414-7440

877 S Orange Blossom Trl
Forest City, FL 32703
Phone (407) 889-3223

7335 W Sand Lake Rd
Ste 125
Orlando, FL 32819
Phone (407) 889-3223

6285 Minton Rd NE
Palm Bay, FL 32907
Phone (321) 306-0300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1174520266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 S FISKE BLVD APT M153",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552573",
            "telephone_number": "914-821-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7335 W SAND LAKE RD STE 125",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195539",
            "telephone_number": "497-930-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JUDD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "deactivation_date": "2007-06-11",
        "reactivation_date": "2007-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.