Active NPI
Donald Ray Hudson, P.T.
- Physical Therapist
- Clovis, NM
National Provider Identifier
1104926443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4795
- Practice address
- 1400 W 21St St
Clovis, NM 88101-4153 - Phone
- (575) 762-4705
- NPI assigned
- Sep 25, 2006
- Last updated
- Jan 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1054674 | TX | |
| Physical Therapist | 225100000X | 4795 | NM | Primary |
Addresses
Primary practice location
1400 W 21St St
Clovis, NM 88101-4153
Mailing address
2215 Dalhart Pass
San Antonio, TX 78245
Phone (210) 455-0469
Other practice location 1
7400 Merton Minter
San Antonio, TX 78229
Phone (210) 617-5300 ext. 16846
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4795 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548547200000",
"number": "1104926443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 DALHART PASS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78245",
"telephone_number": "210-455-0469",
"fax_number": "210-455-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W 21ST ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881014153",
"telephone_number": "575-762-4705"
}
],
"practiceLocations": [
{
"address_1": "7400 Merton Minter",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "78229",
"country_code": "US",
"telephone_number": "210-617-5300 x16846",
"fax_number": "210-949-3094",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUDSON",
"first_name": "DONALD",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2019-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1054674",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.