Individual provider Active NPI

Stephen Hudson, M.D.

  • Emergency Medicine Physician
  • Conway, AR
National Provider Identifier
1083601140
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E0837 Issued in AR
Practice address
2302 College Ave
Conway, AR 72034-6297
Phone
(501) 513-5793
NPI assigned
Oct 4, 2005
Last updated
Jan 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E0837 AR Primary

Addresses

Primary practice location

2302 College Ave
Conway, AR 72034-6297

Mailing address

2302 College Ave
Conway, AR 72034-6297
Phone (501) 513-5793

Other identifiers 1

IdentifierTypeStateIssuer
130948001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090306000015 AR Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 3274699871 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0837ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J.P. Wornock M.D. P.a. CurrentSince Aug 28, 2023 Accepting new patients
J.P. Wornock M.D. P.a. CurrentSince Aug 28, 2023 Accepting new patients
Conway Regional Medical Center, Inc Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Health System Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center, Inc Past Accepting new patients
Conway Emergency Physicians, P.a. Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Mayflower Family Medicine Past Accepting new patients
Conway Emergency Physicians, P.a. Past Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center, Inc Past Accepting new patients

Locations

2504 McCain Blvd
Ste 118
North Little Rock, AR 72116
Phone (501) 812-6655

400 S Main St
Ste 100
Searcy, AR 72143
Phone (501) 279-9000

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1083601140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E0837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130948001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.