Active NPI
Julian Dudley, PT, DPT
- Physical Therapist
- Newport News, VA
National Provider Identifier
1477049526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305212111
- Practice address
- 12494 Warwick Blvd
Newport News, VA 23606-3000 - Phone
- (757) 599-5551
- Fax
- (757) 595-5238
- NPI assigned
- Jul 2, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305212111 | VA | Primary |
Addresses
Primary practice location
12494 Warwick Blvd
Newport News, VA 23606-3000
Mailing address
PO Box 69030
Baltimore, MD 21264-9030
Phone (757) 873-2302
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305212111 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1477049526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69030",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212649030",
"telephone_number": "757-873-2302",
"fax_number": "757-873-2306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12494 WARWICK BLVD",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236063000",
"telephone_number": "757-599-5551",
"fax_number": "757-595-5238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "JULIAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-02",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305212111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.