Charles Vincent Judge III, DOCTOR OF CHIROPRACT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01688 Issued in MD

Practice address

3 Post Office Rd
Suite 104
Waldorf, MD 20602

Phone

(301) 645-5393

Fax

(301) 645-9490

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1851468995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 POST OFFICE RD",
            "address_2": "SUITE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022756",
            "telephone_number": "301-645-5393",
            "fax_number": "301-645-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 POST OFFICE RD",
            "address_2": "SUITE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20602",
            "telephone_number": "301-645-5393",
            "fax_number": "301-645-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "CHARLES",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DOCTOR OF CHIROPRACT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "01688",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MD",
            "identifier": "M199",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF DC",
            "identifier": "T1630001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.