Hudson Family Practice, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HUDSON FAMILY PRACTICE, INC

Practice address

5655 Hudson Dr
Suite 303
Hudson, OH 44236

Phone

(330) 800-4800

Fax

(330) 653-3007

NPI assigned

Feb 12, 2007

Last updated

Jan 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terry John Wagner, D.O.NPI 1679574834

Title

President

Phone

(330) 344-3000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terry John Wagner, D.O.

  • Family Medicine Physician
  • Hudson, OH
  • NPI 1679574834
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Marie Pamfilie, M.D.

  • Family Medicine Physician
  • Hudson, OH
  • NPI 1104817212
  Medicare reassignment Care Compare group NPD
• Jenny L Bodnar, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Hudson, OH
  • NPI 1972054849
  Medicare reassignment NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1063553980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 HUDSON DR",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44236",
            "telephone_number": "330-800-4800",
            "fax_number": "330-653-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 HUDSON DR",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44236",
            "telephone_number": "330-800-4800",
            "fax_number": "330-653-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-344-3000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2152790",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG0422",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hudson City School District
• Hudson Elms
• Hudson Elms Opco, LLC
• Hudson Elms Opco, LLC
• Hudson Family Health Center, Inc.
• Hudson Health and Rehabilitation Center, Inc. (Heritage of Hudson)
• Hudson Health Care, Inc. (Hudson Elms Nursing Home)
• Hudson Laboratories Inc
• Hudson Laboratory Inc
• Hudson Optometric Centre

• Family Medicine Physician in Hudson, OH
• Providers in Hudson, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.