NPIMap

Individual provider Active NPI

Jacqueline Nicole Judd Flack, D.O.

  • Family Medicine Physician
  • Winchester, VA
National Provider Identifier
1679764542
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102202432 Issued in VA
Practice address
104 Selma Dr
Winchester, VA 22601-3834
Phone
(540) 678-2800
Fax
(540) 678-2859
NPI assigned
Aug 6, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102202432 VA Primary
Family Medicine Physician 207Q00000X 0116019842 VA

Addresses

Primary practice location

104 Selma Dr
Winchester, VA 22601-3834

Mailing address

104 Selma Dr
Winchester, VA 22601-3834
Phone (540) 678-2800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjuddflack124109@soc.inova.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000354 VA Practitioner - Family Practice 7113041096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Selma Medical Assoc IncGroup PAC ID 5092618611, 30 clinicians

Practice addresses (Care Compare)

104 Selma Dr
Winchester, VA 22601-3834
Phone (540) 678-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102202432VAMDFamily Medicine Physician
0116019842VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Jan 5, 2011 Accepting new patients
Selma Medical Assoc Inc Family Medicine CurrentSince Aug 1, 2010 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center CurrentSince Jan 5, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

104 Selma Dr
Winchester, VA 22601
Phone (540) 542-6106

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: jacqueline.juddflack@direct.selma.nextgenshare.com
  • Direct secure messaging: jjuddflack124109@soc.inova.org

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1679764542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800",
            "fax_number": "540-678-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800",
            "fax_number": "540-678-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD FLACK",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202432",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116019842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjuddflack124109@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.