Judy B Bain

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

JUDY B BAIN

Practice address

104 Harwell Ave Ste 236
Lagrange, GA 30240-3132

Phone

(706) 885-0111

Fax

(706) 885-0607

NPI assigned

Jun 11, 2019

Organization subpart

No

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

Authorized official

Name

Roxie Moton

Title

Credentialing Specialist

Phone

(706) 594-6073

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judy B. Bain, N.P.

  • Family Nurse Practitioner
  • Jackson, TN
  • NPI 1811133622
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1679132922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HARWELL AVE STE 236",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403132",
            "telephone_number": "706-885-0111",
            "fax_number": "706-885-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HARWELL AVE STE 236",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403132",
            "telephone_number": "706-885-0111",
            "fax_number": "706-885-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY B BAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MOTON",
        "authorized_official_first_name": "ROXIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "706-594-6073"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "electronic",
            "affiliation": "N",
            "address_1": "104 Harwell Ave Ste 236",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302403132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Keating Jones, MD
• Josh Jones, PHARM-D
• Kelly Dudley Jones, APRN
• Joseph Erickson DDS LLC (RAD Orthodontics)
• Valerie Sue Joslin, COTA/L
• K Jackson DMD PC
• Ravina V Kadam, MD
• Dara Whitney Kagan, PHARMD
• Ravi Kumar Kamepalli, M.D.
• Tammi Kaminsky, D.C.

• Clinic/Center in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.