Wayne Hudson DO Integrated Medical Practice PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

WAYNE HUDSON DO INTEGRATED MEDICAL PRACTICE PLLC

Practice address

310 E Olive St
Lamar, CO 81052-2841

Phone

(719) 691-2291

NPI assigned

Jul 12, 2022

Last updated

Dec 7, 2022By 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

Robert Jay Brooke, LCSWNPI 1669806774

Title

Owner/Partner

Phone

(719) 691-2291

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEEJCD

Practitioners 6

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.

• John Phillip Abbott, D.O.

  • Family Medicine Physician
  • Lamar, CO
  • NPI 1255477790
  Medicare reassignment Care Compare group NPD
• Sharon K Headrick, MSW

  • Clinical Social Worker
  • Lamar, CO
  • NPI 1699922971
  Medicare reassignment Care Compare group NPD
• Jodell Wilson Rogers, LCSW

  • Clinical Social Worker
  • Lamar, CO
  • NPI 1093442063
  Medicare reassignment Care Compare group NPD
• Robert Jay Brooke, MSW

  • Clinical Social Worker
  • Lamar, CO
  • NPI 1669806774
  Medicare reassignment Authorized official
• Spencer James McConkie, OD

  • Optometrist
  • Elko, NV
  • NPI 1366890634
  NPD
• Patrick Kevin McGrath, O.D.

  • Optometrist
  • Lamar, CO
  • NPI 1093763138
  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1093449415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E OLIVE ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810522841",
            "telephone_number": "716-931-9844",
            "fax_number": "719-931-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E OLIVE ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810522841",
            "telephone_number": "719-691-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE HUDSON DO INTEGRATED MEDICAL PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "BROOKE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "719-691-2291",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Sue Wagner, M.A.
• Landi Gayle Wagner, BS
• Walmart Inc. (Walmart Pharmacy 10-2672)
• Johnathon Ward
• Patricia Ward
• Laurel R Weakley, FNP-C
• Richard Allen Weakley
• Barbara Joellen Weed, APN
• Daniel James Wessel, PHARMD
• Yvonne Westhoff, RDH

• Multi-Specialty Clinic/Center in Lamar, CO
• Providers in Lamar, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.