NPIMap

Organization Active NPI

Judy PC

Doing business as Claine D Judy D.O.

  • Surgery Physician
  • Pocatello, ID
National Provider Identifier
1528152758
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C143842 Issued in ID
Legal business name
JUDY PC
Doing business as
Claine D Judy D.O.
Practice address
500 S 11TH Ave
Ste 501
Pocatello, ID 83201
Phone
(208) 232-7434
Fax
(208) 233-6446
NPI assigned
Oct 3, 2006
Last updated
Aug 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Dr. Claine Doyle Judy, D.O.
Title
President
Phone
(208) 232-7434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C143842 ID Primary

Addresses

Primary practice location

500 S 11TH Ave
Ste 501
Pocatello, ID 83201

Mailing address

500 S 11TH Ave
Ste 501
Pocatello, ID 83201
Phone (208) 232-7434

Other identifiers 2

IdentifierTypeStateIssuer
8N074OtherIDBLUE CROSS OF IDAHO
806327500MedicaidID

Other names 1

  • CLAINE D JUDY D.O. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1528152758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "address_2": "STE 501",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-7434",
            "fax_number": "208-233-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "address_2": "STE 501",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-7434",
            "fax_number": "208-233-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "CLAINE",
        "authorized_official_middle_name": "DOYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-232-7434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "C143842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8N074",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806327500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLAINE D JUDY D.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.