Grant Judah, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1434 Issued in ND

Practice address

30 7TH St W
Dickinson, ND 58601-4335

Phone

(701) 456-4000

Fax

(701) 456-4387

NPI assigned

Jun 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

Locations

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.

• Sanford Bismarck

  dba Family Wellness

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  NPD

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528260536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829",
            "address_2": "2584 6TH AVE W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586020829",
            "telephone_number": "701-220-4075",
            "fax_number": "701-456-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-456-4000",
            "fax_number": "701-456-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDAH",
        "first_name": "GRANT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Dickinson, ND
• Providers in Dickinson, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.