LISA M JUDGE (NPI# 1932175973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932175973 |
| Entity Type | Individual |
| Full Name | LISA M JUDGE |
| Credential | M D |
| Practice Address |
552 Twin Cities Blvd Suite C Niceville FL 32578-1055 |
| Practice Telephone | 8507291414 |
| Mailing Telephone | 8507291414 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2012-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME0068524 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEMBER PTAN | P00635454 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326327172 | Lisa Marie Judge | Speech-Language Pathologist | 44 Lawson Farm Rd, Londonderry, NH 03053-2671 | 2011-08-11 |
| 1013172659 | Lisa M Judge | Dentist | 1230 Powers Ferry Rd # 6, Marietta, GA 30067 | 2008-07-23 |
| 1952336976 | Lisa Clare Judge | Social Worker | Box 503, 1011 W 31st St, Austin, TX 78705 | 2006-07-11 |
| 1780912311 | Lisa Marie Judge | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2009-11-19 |
| 1114981263 | Lisa Suzanne Judge | Pediatrics | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2006-04-14 |
| Street Address |
552 TWIN CITIES BLVD SUITE C |
| City | NICEVILLE |
| State | FL |
| Zip Code | 32578-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760624704 | Garry G Banks Md Pa | Internal Medicine | 552 Twin Cities Blvd, Suite A, Niceville, FL 32578-1055 | 2009-04-06 |
| 1124220009 | Lisa M Judge M D P A | Obstetrics & Gynecology | 552 Twin Cities Blvd, Suite C, Niceville, FL 32578-1055 | 2007-06-04 |
| 1588631493 | Garry G Banks | Internal Medicine | 552 Twin Cities Blvd, Suite A, Niceville, FL 32578 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1497252860 | Molly Marie Everitt | Physician Assistant | 2190 Fl-85 N, Niceville, FL 32578 | 2018-04-11 |
| 1972009314 | Alexis Aust | Student in an Organized Health Care Education/Training Program | 104 Arrowhead Way, Niceville, FL 32578 | 2018-04-04 |
| 1518488949 | Michelle Sasala | Nurse Practitioner | 4550 E Highway 20, Niceville, FL 32578 | 2017-07-06 |
| 1003336199 | Comfortable Care Denta Health Professionals, Pa | Dentist | 1386 E John Sims Parkway, Niceville, FL 32578 | 2017-06-21 |
| 1306223888 | Emerald Coast Periodontics | Dentist | 719 Bayshore Drive, Niceville, FL 32578 | 2015-05-04 |
| 1538586136 | Pamela Ottesen Dmd LLC | Dentist | 1536 John Sims Pkwy, Niceville, FL 32578 | 2014-03-21 |
| 1417204066 | Mary Jo Stiles | Hearing Instrument Specialist | 4400 Hwy, 20 East, Suite # 211, Niceville, FL 32578 | 2012-08-13 |
| 1093086563 | Pat T. Tidwell Md Pa | Clinic/Center | 4554 Highway 20 East, Niceville, FL 32578 | 2012-01-16 |
| 1952683260 | Gentle Birth Options, LLC | Nurse Practitioner | 296 Bayshore Drive, Niceville, FL 32578 | 2011-09-13 |
| Find all providers in zip 32578 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508123829 | Robert Clark Sledge Jr. | Obstetrics & Gynecology | 4586 E Highway 20 Ste A, Niceville, FL 32578-9724 | 2012-04-12 |
| 1356504799 | Lucy K Rice | Obstetrics & Gynecology | 4586 E Highway 20, Suite A, Niceville, FL 32578-9724 | 2008-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884081 | Radiance Center for Obstetrics and Gynecology LLC | Obstetrics & Gynecology | 653 E Jackson St, Orlando, FL 32801-2809 | 2020-09-02 |
| 1689282162 | Healing Hands Healthcare Services, LLC | Obstetrics & Gynecology | 1900 N Bayshore Dr Apt 2411, Miami, FL 33132-3012 | 2020-07-21 |
| 1790306256 | Mia Donna LLC | Obstetrics & Gynecology | 7100 W 20th Ave Ste 304, Hialeah, FL 33016-1812 | 2020-05-06 |
| 1386265254 | Swfl Integrative Medicine, P.a. | Obstetrics & Gynecology | 1570 Colonial Blvd Ste A, Fort Myers, FL 33907-1031 | 2020-05-02 |
| 1134740061 | Horizon Family Medical Practice LLC | Obstetrics & Gynecology | 1236 Royal Palm Beach Blvd Ste 108, Royal Palm Beach, FL 33411-1602 | 2020-05-01 |
| 1689209991 | Earl Brewster Md Pa | Obstetrics & Gynecology | 101 N 8th St Ste 1001, Lake Mary, FL 32746-3101 | 2020-03-06 |
| 1386276319 | Robert Suruncle Pllc | Obstetrics & Gynecology | 8255 N Wickham Rd Ste 102, Melbourne, FL 32940-8202 | 2020-02-07 |
| 1376182329 | Moment Health Care Inc | Obstetrics & Gynecology | 6464 N Miami Ave, Miami, FL 33150-4520 | 2019-12-21 |
| 1043858012 | Medical Vitality Clinic LLC | Obstetrics & Gynecology | 1845 Cordova Rd Ste 204, Fort Lauderdale, FL 33316-6100 | 2019-12-20 |
| 1679124986 | Brenda Sison Wilkinson | Obstetrics & Gynecology | 2050 Ackola Pt, Longwood, FL 32779-3112 | 2019-09-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.