Individual provider Active NPI

Judd T Laurie, D.C.

  • Chiropractor
  • Edgewater, FL
National Provider Identifier
1609047224
Registry record updated Mar 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9483 Issued in FL
Practice address
2331 S Ridgewood Ave
Edgewater, FL 32141-4228
Phone
(386) 423-3100
NPI assigned
Mar 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9483 FL Primary

Addresses

Primary practice location

2331 S Ridgewood Ave
Edgewater, FL 32141-4228

Mailing address

2331 S Ridgewood Ave
Edgewater, FL 32141-4228

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH9483FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1206230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206230400000",
    "number": "1609047224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 S RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321414228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 S RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321414228",
            "telephone_number": "386-423-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIE",
        "first_name": "JUDD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-23",
        "last_updated": "2008-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2008; 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.