Individual provider Active NPI

Judy L. Caldwell, DO

  • Family Medicine Physician
  • St George, UT
National Provider Identifier
1679673420
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9897237-1204 Issued in UT
Practice address
1240 E 100 S Ste 17B
Saint George, UT 84790-3074
Phone
(435) 703-9499
Fax
(435) 477-6990
NPI assigned
Sep 22, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO1441 NV
Geriatric Medicine (Family Medicine) Physician 207QG0300X 9897237-1204 UT
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 9897237-1204 UT
Family Medicine Physician 207Q00000X 20A6927 CA
Family Medicine Physician 207Q00000X 9897237-1204 UT Primary

Addresses

Primary practice location

1240 E 100 S Ste 17B
Saint George, UT 84790-3074

Mailing address

1240 E 100 S Ste 17B
Saint George, UT 84790-3074
Phone (435) 703-9499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710002650 UT Order and Referring Only - Family PracticePractitioner - Family Practice 7911912985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO1441NVMDFamily Medicine Physician
9897237-1204UTMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Hospice and Palliative Care, Inc. Family Medicine CurrentSince Jun 30, 2024 Accepting new patients
California Care Level Management Direct Medical Group, Inc PastSince Jun 26, 2006 Accepting new patients

Locations

1240 E 100 S
Ste 17B
St George, UT 84790
Phone (435) 477-6999

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pathway Hospice and Palliative Care IncSt George, UT, CCN 461624 Hospice Contracted Managing Employee (20%)
Operational/Managerial Control (20%)
Jul 16, 2020
Jul 16, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1679673420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 17B",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847903074",
            "telephone_number": "435-703-9499",
            "fax_number": "435-477-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 17B",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847903074",
            "telephone_number": "435-703-9499",
            "fax_number": "435-477-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JUDY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO1441",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "9897237-1204",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "9897237-1204",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6927",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9897237-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.