MARY ELAINE JUDD (NPI# 1114975661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114975661 |
| Entity Type | Individual |
| Full Name | MARY ELAINE JUDD |
| Credential | PA-C |
| Practice Address |
141 Corliss Ln Indian Stream Health Center, Inc Colebrook NH 03576-3206 |
| Practice Telephone | 6032378336 |
| Practice Fax Number | 6032374467 |
| Mailing Telephone | 6032378336 |
| Mailing Fax Number | 6032374467 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2008-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0192 P | NH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30005368 | 05 | |
| AETNA | 7626041 | 01 | |
| VT | BCBS OF VT | 00029222 | 01 |
| MVP HEALTHPLANS | 394376 | 01 | |
| VT | OAP1435 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013237916 | Mary Jennette Judd | Anesthesiology | 600 Green Valley Rd Ste 304, Greensboro, NC 27408-7722 | 2010-06-03 |
| 1134518509 | Mary Judd | Case Manager/Care Coordinator | 210 N Shamrock Blvd, Russellville, AR 72802-9658 | 2015-01-22 |
| 1689874380 | Mary Elayne-assenmacher Judd | Nurse Practitioner | 1500 East Medical Center Dr, 3rd Floor Cardiovascular Center Recp C, Ann Arbor, MI 48109-5864 | 2007-07-20 |
| Street Address |
141 CORLISS LN INDIAN STREAM HEALTH CENTER, INC |
| City | COLEBROOK |
| State | NH |
| Zip Code | 03576-3206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891328704 | Aimee Katherine Berry | Social Worker | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2020-02-19 |
| 1477117182 | Kristi Ann Samson-smith | Internal Medicine | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2019-04-29 |
| 1093254401 | Mackenzie June Dufour | Physician Assistant | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2017-02-17 |
| 1497205884 | Yoomi Lee | Registered Nurse | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2016-10-10 |
| 1154735108 | Laurie Connors | Social Worker | 141 Corliss Ln, Indian Stream Health Center, Colebrook, NH 03576 | 2014-06-18 |
| 1659706307 | Amanda Elizabeth Mcgerigle | Social Worker | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2013-09-12 |
| 1962846162 | April Allin | Pharmacist | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2013-04-18 |
| 1790023604 | Indian Stream Health Center Inc | Pharmacy | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2013-01-28 |
| 1164776431 | Bonnie Lynn Balsamo | Counselor | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2012-11-07 |
| 1669616322 | Elizabeth Rachel Sweeney | Family Medicine | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2009-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255845905 | Expressmed, LLC | Physician Assistant | 152 Colby Street, Colebrook, NH 03576 | 2017-11-16 |
| 1619225331 | Sheila J. Parkhurst | Mechanotherapist | 53 Trooper Leslie Lord Mem. Hwy., Colebrook, NH 03576 | 2012-08-28 |
| 1205972874 | John Carmelo Gramuglia | Counselor | 4 Titus Hill Rd, Colebrook, NH 03576 | 2007-01-30 |
| 1205905338 | Eckerd Youth Alternatives Inc | Residential Treatment Facility, Emotionally Disturbed Children | 35 Eckerd Way, Stewartstown, NH 03576 | 2006-11-06 |
| 1386673952 | Indian Stream Health Center, Inc | General Practice | 141 Corliss Lane, Colebrook, NH 03576 | 2006-07-03 |
| 1134178775 | Rebecca M Underwood | Physical Therapist | 118 Main St Ste 6, Colebrook, NH 03576 | 2006-05-10 |
| 1861489437 | Upper Connecticut Valley Hospital Association | General Acute Care Hospital | 181 Corliss Lane, Colebrook, NH 03576 | 2005-09-29 |
| 1992204168 | Donald Murray Dickson | Pharmacist | 91 Main St, Colebrook, NH 03576 | 2018-02-02 |
| 1083133870 | North Country Medical and Wellness, LLC | Clinic/Center | 152 Colby St, Colebrook, NH 03576 | 2017-09-13 |
| 1053561001 | Darwin A Castor | Nurse Anesthetist, Certified Registered | 181 Corliss Lane, Ucvh, Colebrook, NH 03576 | 2008-09-26 |
| Find all providers in zip 03576 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255845905 | Expressmed, LLC | Physician Assistant | 152 Colby Street, Colebrook, NH 03576 | 2017-11-16 |
| 1548219728 | Faye Memolo | Physician Assistant | 187 Main St, Apt. 6, Colebrook, NH 03576-2012 | 2006-05-08 |
| 1093254401 | Mackenzie June Dufour | Physician Assistant | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2017-02-17 |
| 1093170169 | Kelsey Marie Skillin | Physician Assistant | 152 Colby St, Colebrook, NH 03576-3049 | 2015-12-16 |
| 1013156801 | Stefanie A Carone | Physician Assistant | 141 Corliss Ln, Colebrook, NH 03576-3206 | 2009-02-18 |
| 1518029933 | Kathryn R Martin | Physician Assistant | 152 Colby St, Colebrook, NH 03576-3049 | 2006-12-14 |
| 1366432478 | Edward Joseph Laverty | Physician Assistant | 181 Corliss Ln, Colebrook, NH 03576-3207 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151959 | Sara Sverker | Physician Assistant | 11b Danville Rd, Plaistow, NH 03865-2719 | 2020-10-15 |
| 1306444641 | Zachary Wright | Physician Assistant | 11 Harley Ln, Salem, NH 03079-2888 | 2020-10-09 |
| 1619584869 | Elizabeth Fiorentino | Physician Assistant | 500 Market St Unit 1e, Portsmouth, NH 03801-3456 | 2020-09-30 |
| 1861009334 | Sarah Elizabeth Smith | Physician Assistant | 10 Hampshire Hills Dr, Bow, NH 03304-4920 | 2020-09-28 |
| 1366050841 | Richard Charity | Physician Assistant | 44 Adams Pond Rd, Derry, NH 03038-5013 | 2020-07-21 |
| 1578183927 | Cara Weiner | Physician Assistant | 200 Old Dublin Rd, Peterborough, NH 03458-1335 | 2020-04-24 |
| 1871126581 | Ernest K Tabiri | Physician Assistant | 12 Fairway Dr Apt 1412, Derry, NH 03038-6156 | 2020-02-20 |
| 1578103479 | Mary Seaman | Physician Assistant | 497 Hooksett Rd # 142, Manchester, NH 03104-2632 | 2020-01-09 |
| 1144869546 | Jared W Swain | Physician Assistant | 7 Kimball St Apt 20, Lebanon, NH 03766-1736 | 2020-01-02 |
| 1275184970 | Jillian Mccolgan | Physician Assistant | 111 Nh Ave Ste 2, Portsmouth, NH 03801-2864 | 2019-09-24 |
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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.