Individual provider Active NPI

Janice M Hudson, M.D.

  • Family Medicine Physician
  • Gulf Breeze, FL
National Provider Identifier
1104960483
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME85664 Issued in FL
Practice address
6031 Blair Cir
Gulf Breeze, FL 32563-7064
Phone
(850) 934-9856
Fax
(888) 224-9066
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME85664 FL Primary

Addresses

Primary practice location

6031 Blair Cir
Gulf Breeze, FL 32563-7064

Mailing address

6031 Blair Cir
Gulf Breeze, FL 32563-7064
Phone (850) 934-9856

Other identifiers 2

IdentifierTypeStateIssuer
ME85664OtherFLMEDICAL LICENSE
23235OtherALALABAMA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040614001150 FL Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Pain Management 8325022841 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23635ALMDPharmacist
ME85664FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman Medical Group, LLC CurrentSince Jan 1, 2023 Accepting new patients
Baptist Physician Associates LLC Family Medicine Past Accepting new patients

Organizations & group practices 2

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1104960483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 BLAIR CIR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325637064",
            "telephone_number": "850-934-9856",
            "fax_number": "888-224-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 BLAIR CIR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325637064",
            "telephone_number": "850-934-9856",
            "fax_number": "888-224-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JANICE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME85664",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSE",
            "identifier": "23235",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.