Active NPI
Ross Judice, MD
- Psychiatry Physician
- Bend, OR
National Provider Identifier
1558368514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD161138
- Practice address
- 2542 NE Courtney Dr
Bend, OR 97701-7685 - Phone
- (541) 706-4841
- Fax
- (541) 706-7706
- NPI assigned
- Jul 6, 2005
- Last updated
- Aug 20, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 021000 | LA | |
| Psychiatry Physician | 2084P0800X | MD161138 | OR | Primary |
Addresses
Primary practice location
2542 NE Courtney Dr
Bend, OR 97701-7685
Mailing address
2542 NE Courtney Dr
Bend, OR 97701-7685
Phone (541) 706-4841
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021000 | LA | MD | Psychiatry Physician |
| MD161138 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1558368514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2542 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017685",
"telephone_number": "541-706-4841",
"fax_number": "541-706-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2542 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017685",
"telephone_number": "541-706-4841",
"fax_number": "541-706-7706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDICE",
"first_name": "ROSS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "021000",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD161138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.