Active NPI
Kimberly Nichelle Hudson, LPN
- Licensed Practical Nurse
- Columbus, OH
National Provider Identifier
1063749349
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 18, 2021.
- Section 1128a(1) exclusion effective May 19, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 134111
- Practice address
- 466 Wellington Willows Way
Columbus, OH 43213-6650 - Phone
- (614) 394-6701
- NPI assigned
- Nov 7, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 134111 | OH | Primary |
Addresses
Primary practice location
466 Wellington Willows Way
Columbus, OH 43213-6650
Mailing address
466 Wellington Willows Way
Columbus, OH 43213-6650
Phone (614) 394-6701
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134111 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257552000000",
"number": "1063749349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "466 WELLINGTON WILLOWS WAY",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432136650",
"telephone_number": "614-394-6701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "466 WELLINGTON WILLOWS WAY",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432136650",
"telephone_number": "614-394-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "KIMBERLY",
"middle_name": "NICHELLE",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-07",
"last_updated": "2009-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "134111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.