Individual provider Active NPI

Brent Hudson

  • Pharmacist
  • Augusta, GA
National Provider Identifier
1053580993
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH023645 Issued in GA
Practice address
2604 Peach Orchard Rd
Augusta, GA 30906-2406
Phone
(706) 798-5645
NPI assigned
Feb 25, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

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

LicenseStateTypeSpecialty
RPH023645GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Louisville Project, LLC Current Accepting new patients
Bryant and Hudson Current Accepting new patients
The Louisville Project, LLC Current Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH023645 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

2604 Peach Orchard Rd
Augusta, GA 30906-2406

Mailing address

2604 Peach Orchard Rd
Augusta, GA 30906-2406

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
332660172AMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 24, 2015.

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1053580993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 PEACH ORCHARD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 PEACH ORCHARD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062406",
            "telephone_number": "706-798-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH023645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332660172A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.