Individual provider Active NPI

Kenneth Patrick Judd, M.D.

  • Dermatology Physician
  • Cambridge, MD
National Provider Identifier
1366416810
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D22122 Issued in MD
Practice address
100 Bramble St
Suite 1
Cambridge, MD 21613-2408
Phone
(410) 228-8106
Fax
(410) 228-8390
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D22122 MD Primary

Addresses

Primary practice location

100 Bramble St
Suite 1
Cambridge, MD 21613-2408

Mailing address

1758 Travers Wharf Rd
Cambridge, MD 21613-9500
Phone (410) 901-9368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180327000060 SC Practitioner - Dermatology 2365583853 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D22122MDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Fix SC LLC Dermatology CurrentSince Feb 28, 2022 Accepting new patients

Locations

1520 Two Notch Rd SE
Aiken, SC 29803
Phone (803) 649-3909

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366416810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1758 TRAVERS WHARF RD",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216139500",
            "telephone_number": "410-901-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRAMBLE ST",
            "address_2": "SUITE 1",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132408",
            "telephone_number": "410-228-8106",
            "fax_number": "410-228-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "KENNETH",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D22122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

Verify at the official NPI Registry.