Elizabeth Judd LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ELIZABETH JUDD LLC

Practice address

2025 S Brentwood Blvd Ste 202
Brentwood, MO 63144-1851

Phone

(314) 606-9467

NPI assigned

Dec 9, 2021

Organization subpart

No

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

Authorized official

Name

Elizabeth JuddNPI 1629021597

Title

Owner

Phone

(314) 606-9467

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Mullanphy Judd, CPNP, PMHS

  • Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
  • Saint Louis, MO
  • NPI 1629021597
  NPD Authorized official

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1831858562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S BRENTWOOD BLVD STE 202",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631441851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S BRENTWOOD BLVD STE 202",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631441851",
            "telephone_number": "314-606-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH JUDD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-606-9467"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Brentwood, MO
• Providers in Brentwood, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.