Bobby Dante' Judd

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL092189 Issued in NC

Practice address

221 E Barbee St
Zebulon, NC 27597-2811

Phone

(919) 404-0628

NPI assigned

May 2, 2014

Last updated

May 2, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jackson Family Care

  • Mental Illness Community Based Residential Treatment Facility
  • Zebulon, NC
  • NPI 1689720476
  NPD (past)

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1356751085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E BARBEE ST",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275972811",
            "telephone_number": "919-404-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E BARBEE ST",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275972811",
            "telephone_number": "919-404-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "BOBBY",
        "middle_name": "DANTE'",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL092189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Zebulon, NC
• Providers in Zebulon, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.