Judith Ryan Clary, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110005075 Issued in VA

Practice address

2000 N Beauregard St
Suite 330
Alexandria, VA 22311-1748

Phone

(703) 370-2400

Fax

(703) 370-7214

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Judith Marie Coddington Former name

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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.

• Jeremy J. Janssen, M.D., P.C.

  • Family Medicine Physician
  • Gaithersburg, MD
  • NPI 1891826392

  DC

  Medicare reassignment

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1841587789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N BEAUREGARD ST",
            "address_2": "SUITE 330",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111748",
            "telephone_number": "703-370-2400",
            "fax_number": "703-370-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N BEAUREGARD ST",
            "address_2": "SUITE 330",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111748",
            "telephone_number": "703-370-2400",
            "fax_number": "703-370-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY",
        "first_name": "JUDITH",
        "middle_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006132",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005383",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112418C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "CODDINGTON",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Clark, BCBA
• Thomas H Clark, MD
• Tilden David Clark, O.D.
• Aaliyah Clarke
• Cynthia Clarke, PT
• Classic Nurses Services Inc
• Classic Nurses Services Inc.
• Alycia Clayton, LCSW
• Grace Elizabeth Cleary
• Kelly Nicole Clemente, LPCC

• Medical Physician Assistant in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.