Molly S Judge DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

2877 Issued in OH

Legal business name

MOLLY S JUDGE DPM

Practice address

530 Washington Street
Port Clinton, OH 43452-1935

Phone

(419) 732-2618

Fax

(419) 732-1998

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Molly S Judge, DPM

Title

Owner

Phone

(419) 732-2618

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• North West Ohio Foot and Ankle LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Molly S Judge, DPM

  • Foot & Ankle Surgery Podiatrist
  • Port Clinton, OH
  • NPI 1740234657

  O20100930029188

  Same enrollment

Locations

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1801065545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 WASHINGTON STREET",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521935",
            "telephone_number": "419-732-2618",
            "fax_number": "419-732-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 WASHINGTON STREET",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521935",
            "telephone_number": "419-732-2618",
            "fax_number": "419-732-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLLY S JUDGE DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "JUDGE",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-732-2618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "2877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEMBCBS",
            "identifier": "000000142130",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019774",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "4855810540",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134887318",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North West Ohio Foot and Ankle LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.