Active NPI
Daniel Kenan Judge, D.C.
- Chiropractor
- Grand Haven, MI
National Provider Identifier
1184832917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DJ002540
- Practice address
- 16964 Robbins Rd
Suite 100 B
Grand Haven, MI 49417-2796 - Phone
- (616) 935-7599
- Fax
- (616) 935-7598
- NPI assigned
- May 17, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DJ002540 | MI | Primary |
Addresses
Primary practice location
16964 Robbins Rd
Suite 100 B
Grand Haven, MI 49417-2796
Mailing address
16964 Robbins Rd
Suite 100 B
Grand Haven, MI 49417-2796
Phone (616) 935-7599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090603000019 | MI | Practitioner - Chiropractic | 8224063045 | Practice locations: Grand Haven, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1970
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
16964 Robbins Rd
Grand Haven, MI 49417-2796
Phone (616) 935-7599
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3694 | AZ | MD | Clinical Psychologist |
| DJ002540 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496275200000",
"number": "1184832917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16964 ROBBINS RD",
"address_2": "SUITE 100 B",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494172796",
"telephone_number": "616-935-7599",
"fax_number": "616-935-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16964 ROBBINS RD",
"address_2": "SUITE 100 B",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494172796",
"telephone_number": "616-935-7599",
"fax_number": "616-935-7598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDGE",
"first_name": "DANIEL",
"middle_name": "KENAN",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2017-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "DJ002540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; 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.