Mackenzie Dianne Hudson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1890 SW Health Pkwy Ste 205
Naples, FL 34109-0473

Phone

(239) 449-7979

NPI assigned

Mar 30, 2021

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1073191391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 SWEETGRASS CIR UNIT 307",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341040898",
            "telephone_number": "339-237-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SW HEALTH PKWY STE 205",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341090473",
            "telephone_number": "239-449-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "MACKENZIE",
        "middle_name": "DIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janneke Huber, PT
• Jeremy Michael Hudak
• James Irvin Huddleston Jr., M.D.
• Hudson Valley Radiologists, PC
• Joe Hudson Jr., CAP
• Paige Elizabeth Hudson
• Thomas D Hudson, M.D.
• Kristi Louise Huenefeld, ATC
• Brian Huffman
• Thomas Andrew Hufford, CRNA

• Physician Assistant in Naples, FL
• Providers in Naples, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.