Individual provider Active NPI

Judith Lee Ponder Handley, MD

  • Pediatric Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1801083993
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
25998 Issued in OK
Practice address
920 Stanton L Young Blvd Dept of
Oklahoma City, OK 73104-5036
Phone
(405) 271-4351
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 25998 OK Primary

Addresses

Primary practice location

920 Stanton L Young Blvd Dept of
Oklahoma City, OK 73104-5036

Mailing address

920 Stanton L Young Blvd Dept of
Oklahoma City, OK 73104-5036
Phone (405) 271-4351

Other practice location 1

800 Rose St # N212
Department of Anesthesiology
Lexington, KY 40536-0293
Phone (859) 218-0097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190718002254 GA Practitioner - Anesthesiology 1557441102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Georgia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP789KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Anesthesia Billing Services, LLC CurrentSince Jun 1, 2019 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1801083993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD DEPT OF",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD DEPT OF",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St # N212",
            "address_2": "Department of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-218-0097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANDLEY",
        "first_name": "JUDITH",
        "middle_name": "LEE PONDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "OK",
            "license": "25998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.