Active NPI
Michael Donald Judd, R.PH.
- Pharmacist
- Ithaca, NY
National Provider Identifier
1356635320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 040201
- Practice address
- 101 Dates Dr
Ithaca, NY 14850-1342 - Phone
- (607) 274-4394
- NPI assigned
- Jun 7, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 040201 | NY | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | 040201 | NY |
Addresses
Primary practice location
101 Dates Dr
Ithaca, NY 14850-1342
Mailing address
101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040201 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1356635320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 DATES DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501342",
"telephone_number": "607-274-4394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 DATES DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501342",
"telephone_number": "607-274-4394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDD",
"first_name": "MICHAEL",
"middle_name": "DONALD",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-07",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "040201",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NY",
"license": "040201",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.