Individual provider Active NPI

Dana Crystal Mosure-Judge, D.C.

  • Sports Physician Chiropractor
  • Birmingham, MI
National Provider Identifier
1942583885
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2301009849 Issued in MI
Practice address
219 Elm St
Birmingham, MI 48009-6341
Phone
(248) 645-6070
Fax
(248) 645-2949
NPI assigned
Sep 27, 2011
Last updated
Mar 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2301009849 MI Primary

Addresses

Primary practice location

219 Elm St
Birmingham, MI 48009-6341

Mailing address

219 Elm St
Birmingham, MI 48009-6341
Phone (248) 645-6070

Other names 1

  • Dana Crystal Mosure Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130204000564 MI Practitioner - Chiropractic 5698929354 Practice locations: Lake Orion, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

214 S Broadway St
Lake Orion, MI 48362-4203
Phone (248) 783-7169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Sports Chiropractic PastSince Dec 20, 2014 Accepting new patients
Birmingham Wellness Center PLLC PastSince Nov 1, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1942583885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 ELM ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096341",
            "telephone_number": "248-645-6070",
            "fax_number": "248-645-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 ELM ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096341",
            "telephone_number": "248-645-6070",
            "fax_number": "248-645-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSURE-JUDGE",
        "first_name": "DANA",
        "middle_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301009849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "MOSURE",
            "middle_name": "CRYSTAL",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.