Individual provider Active NPI

Lindsay Hudson, LPN

  • Licensed Practical Nurse
  • Carbondale, IL
National Provider Identifier
1104261999
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043112285 Issued in IL
Practice address
305 W Jackson St Ste 402
Carbondale, IL 62901-1474
Phone
(618) 529-4711
Fax
(618) 998-8808
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043112285 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 402
Carbondale, IL 62901-1474

Mailing address

500 Rushing Dr
Herrin, IL 62948-3748
Phone (618) 998-8808

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

State licenses

LicenseStateTypeSpecialty
043112285ILMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois OB-GYN Associates, S.C. PastSince Jan 1, 1998 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1104261999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RUSHING DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483748",
            "telephone_number": "618-998-8808",
            "fax_number": "618-998-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 402",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-529-4711",
            "fax_number": "618-998-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "LINDSAY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043112285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.