Individual provider Active NPI

Tina Ann Judge, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fishersville, VA
National Provider Identifier
1174591606
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
MJ0925985 Issued in VA
Practice address
9 Pinnacle Dr
Suite 105
Fishersville, VA 22939-2366
Phone
(540) 688-2646
Fax
(540) 688-2656
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X MJ0925985 VA Primary

Addresses

Primary practice location

9 Pinnacle Dr
Suite 105
Fishersville, VA 22939-2366

Mailing address

53 Erem Way
Fishersville, VA 22939-2132
Phone (540) 256-7302

Other identifiers 1

IdentifierTypeStateIssuer
7794398MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Health Systems,PLC Psychiatric/Mental Health PastSince Nov 1, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tjudge@momentum.kareodirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1174591606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 EREM WAY",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392132",
            "telephone_number": "540-256-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PINNACLE DR",
            "address_2": "SUITE 105",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392366",
            "telephone_number": "540-688-2646",
            "fax_number": "540-688-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "TINA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "MJ0925985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7794398",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.