Individual provider Active NPI

Judith Marie Adams, N.P.-C.

  • Primary Care Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1679625321
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704200168 Issued in MI
Practice address
20755 Greenfield Rd
Suite #203
Southfield, MI 48075-5403
Phone
(248) 395-2206
Fax
(248) 395-0456
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704200168 MI
Primary Care Nurse Practitioner 363LP2300X 4704200168 MI Primary

Addresses

Primary practice location

20755 Greenfield Rd
Suite #203
Southfield, MI 48075-5403

Mailing address

20755 Greenfield Rd
Suite #203
Southfield, MI 48075-5403
Phone (248) 395-2206

Other identifiers 1

IdentifierTypeStateIssuer
4704200168OtherMINP LICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
4704200168MIMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679625321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20755 GREENFIELD RD",
            "address_2": "SUITE #203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755403",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20755 GREENFIELD RD",
            "address_2": "SUITE #203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755403",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "N.P.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704200168",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704200168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "4704200168",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.