Judy S Brummer, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-107334 Issued in IL

Practice address

10874 E 2000TH Ave
Shumway, IL 62461-2267

Phone

(217) 821-1428

NPI assigned

Jul 17, 2006

Last updated

Jul 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jbrumm02@yourcarecommunity.org

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1346267895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10874 E 2000TH AVE",
            "city": "SHUMWAY",
            "state": "IL",
            "postal_code": "624612267",
            "telephone_number": "217-868-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10874 E 2000TH AVE",
            "city": "SHUMWAY",
            "state": "IL",
            "postal_code": "624612267",
            "telephone_number": "217-821-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMER",
        "first_name": "JUDY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-107334",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "57-000425",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MDR-4086",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107334",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Awakened Actions, LLC.
• Ashley Suzannah Bradshaw, M.S., R.D.,L.D.N
• Alyssa Ann Pruemer
• Mary Margaret Slifer, PTA

• Emergency Medicine Physician in Shumway, IL
• Providers in Shumway, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.