Individual provider Active NPI

Patricia Judson, FNP

  • Primary Care Nurse Practitioner
  • Ventura, CA
National Provider Identifier
1760735567
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
22509 Issued in CA
Practice address
5349 Queens St
Ventura, CA 93003-3946
Phone
(805) 701-4804
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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 22509 CA
Primary Care Nurse Practitioner 363LP2300X 22509 CA Primary

Addresses

Primary practice location

5349 Queens St
Ventura, CA 93003-3946

Mailing address

5349 Queens St
Ventura, CA 93003-3946
Phone (805) 701-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329002039 SC Practitioner - Nurse Practitioner 4486092244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowcountry Urgent Care LLCGroup PAC ID 9739210337, 81 clinicians

Practice addresses (Care Compare)

182 C Sea Island Pkwy
Beaufort, SC 29907-1503
Phone (843) 322-1933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22509CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urgent Care LLC Primary Care CurrentSince Feb 14, 2024 Accepting new patients

Locations

182C Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 322-1933

1515 Bells Hwy
Walterboro, SC 29488
Phone (843) 522-8223

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1760735567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 QUEENS ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033946",
            "telephone_number": "805-701-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5349 QUEENS ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033946",
            "telephone_number": "805-701-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDSON",
        "first_name": "PATRICIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22509",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "22509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.