NPIMap

Individual provider Active NPI

Jennifer H. Judkins, M.D.

  • Specialist
  • Lebanon, NH
National Provider Identifier
1902850332
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12996 Issued in NH
Practice address
106 Hanover St
Lebanon, NH 03766-1042
Phone
(603) 448-0447
Fax
(603) 448-1089
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12996 NH Primary

Addresses

Primary practice location

106 Hanover St
Lebanon, NH 03766-1042

Mailing address

106 Hanover St
Lebanon, NH 03766-1042
Phone (603) 448-0447

Other identifiers 2

IdentifierTypeStateIssuer
1012413MedicaidVT
30205893MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000506 VT Practitioner - Otolaryngology 7618937152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical College of Ohio, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

51 A Tennis Way
Rutland Regional Medical Center
East Dorset, VT 05253-4410
Phone (802) 366-8195

Hospital & facility affiliations

  • Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005
  • Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12996NHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc. CurrentSince Feb 13, 2013 Accepting new patients
Rutland Hospital, Inc. Specialist CurrentSince Feb 13, 2013 Accepting new patients
Upper Valley Neurology Neurosurgery,PC Specialist Past Accepting new patients
ENT and Allergy Inc PastSince Jun 1, 1995 Accepting new patients
Rutland Hospital, Inc Past Accepting new patients

Locations

51A Tennis Way
East Dorset, VT 05253
Phone (802) 366-8195

69 Allen St
Rutland, VT 05701
Phone (802) 747-1628

160 Allen St
Rutland, VT 05701

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/

Organizations & group practices 5

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 4

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1902850332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HANOVER ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661042",
            "telephone_number": "603-448-0447",
            "fax_number": "603-448-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HANOVER ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661042",
            "telephone_number": "603-448-0447",
            "fax_number": "603-448-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDKINS",
        "first_name": "JENNIFER",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NH",
            "license": "12996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012413",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30205893",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.