Jude Waterbury Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A90991 Issued in CA

Legal business name

JUDE WATERBURY INC

Practice address

8100 Timberlake Way
#D
Sacramento, CA 95823-5409

Phone

(916) 689-8606

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Jude Waterbury, MD

Title

Physician Owner

Phone

(916) 689-8606

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1255540241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 TIMBERLAKE WAY",
            "address_2": "#D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235409",
            "telephone_number": "916-689-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 TIMBERLAKE WAY",
            "address_2": "#D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235409",
            "telephone_number": "916-689-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDE WATERBURY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "WATERBURY",
        "authorized_official_first_name": "JUDE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "916-689-8606",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A90991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A909910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A909910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE3856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Monserrath Juarez
• Vianey Juarez
• Adriana Jucu
• Kayla Judd
• Scott W Judd, PT
• Morgan Jude
• Keith Michael Judelman, FNP, RN, EAMP
• Kandeel K Judge, M.D.
• Roopa Judge
• Sean James Judge, MD

• Internal Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.