NPIMap

Organization Active NPI

Hudson Physicians, S.C

Doing business as Hudson Physicians

  • Family Medicine Physician
  • Baldwin, WI
National Provider Identifier
1093238347
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HUDSON PHYSICIANS, S.C
Doing business as
Hudson Physicians
Practice address
840 Spruce St
Baldwin, WI 54002-3264
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Jul 19, 2017
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Ernie Wallin
Title
Administrator
Phone
(715) 531-6862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

840 Spruce St
Baldwin, WI 54002-3264

Mailing address

2651 Hillcrest Dr Ste 303
Hudson, WI 54016-9919
Phone (715) 531-6800

Other names 1

  • Hudson Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131031000204 WI Part B Supplier - Clinic/Group Practice 2668607557 Receives reassigned benefits from 79 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Richmond, WI; Hudson, WI; Baldwin, WI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hudson Physicians SC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/42a1ed53-a9ac-42b2-918f-be592f726951/

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1093238347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DR STE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169919",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SPRUCE ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540023264",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON PHYSICIANS, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "ERNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-531-6862"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baldwin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.