Active NPI
Cameron Judge, LAT,ATC
- Athletic Trainer
- Scranton, PA
National Provider Identifier
1942897392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000020001
- Practice address
- 1800 Mulberry St
Scranton, PA 18510-2369 - Phone
- (570) 703-8000
- NPI assigned
- Dec 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000020001 | PA | Primary |
Addresses
Primary practice location
1800 Mulberry St
Scranton, PA 18510-2369
Mailing address
9 Pope Ter
Mountain Top, PA 18707-9515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000020001 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609286400000",
"number": "1942897392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 POPE TER",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187079515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MULBERRY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185102369",
"telephone_number": "570-703-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDGE",
"first_name": "CAMERON",
"credential": "LAT,ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-30",
"last_updated": "2020-12-30",
"certification_date": "2020-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "2000020001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.