Individual provider Active NPI

Judith A Deschamps, RN, MSN, NP-C

  • Adult Health Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1508971078
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN167699 Issued in OH
Practice address
125 E Broad St
Suite 305
Elyria, OH 44035-6400
Phone
(440) 414-9100
Fax
(440) 322-4104
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN167699 OH Primary

Addresses

Primary practice location

125 E Broad St
Suite 305
Elyria, OH 44035-6400

Mailing address

29325 Health Campus Dr
Suite 3
Westlake, OH 44145-8201
Phone (440) 414-9412

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOH

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
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN167699OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olmsted Health & Services Corp. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jdeschamps28127@ehrdirect.uhhospitals.org

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1508971078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29325 HEALTH CAMPUS DR",
            "address_2": "SUITE 3",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441458201",
            "telephone_number": "440-414-9412",
            "fax_number": "440-414-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE 305",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-414-9100",
            "fax_number": "440-322-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESCHAMPS",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN167699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.