Individual provider Active NPI

Judith Annette Kemp, D.O.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1255512430
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6980 Issued in CA
Practice address
11347 McBurney Ridge LN
San Diego, CA 92131-2940
Phone
(858) 245-2855
Fax
(858) 566-4383
NPI assigned
Nov 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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 20A6980 CA Primary

Addresses

Primary practice location

11347 McBurney Ridge LN
San Diego, CA 92131-2940

Mailing address

11347 McBurney Ridge LN
San Diego, CA 92131-2940
Phone (858) 245-2855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140505000348 CA Order and Referring Only - Family PracticePractitioner - Family Practice 5597735746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6980CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1255512430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11347 MCBURNEY RIDGE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312940",
            "telephone_number": "858-245-2855",
            "fax_number": "858-566-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11347 MCBURNEY RIDGE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312940",
            "telephone_number": "858-245-2855",
            "fax_number": "858-566-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "JUDITH",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.