Active NPI
Douglas Paul Hudson, MD
- Family Medicine Physician
- Brookfield, CT
National Provider Identifier
1114936341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 027540
- Practice address
- 304 Federal Rd
Suite 109
Brookfield, CT 06804-2418 - Phone
- (203) 775-5555
- Fax
- (203) 775-0782
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 147232 | NY | |
| Family Medicine Physician | 207Q00000X | 027540 | CT | Primary |
Addresses
Primary practice location
304 Federal Rd
Suite 109
Brookfield, CT 06804-2418
Mailing address
1034 Hanover St
Yorktown Heights, NY 10598-5914
Phone (914) 962-1585
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027540 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WRK Ventures, LLC | Past | Accepting new patients |
Interoperability endpoints
- douglas.hudson@ghuc.eclinicaldirectplus.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Urgent Care of Southbury
- Urgent Care Clinic/Center
- Southbury, CT
- NPI 1194993980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114936341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 HANOVER ST",
"city": "YORKTOWN HEIGHTS",
"state": "NY",
"postal_code": "105985914",
"telephone_number": "914-962-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 FEDERAL RD",
"address_2": "SUITE 109",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068042418",
"telephone_number": "203-775-5555",
"fax_number": "203-775-0782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "DOUGLAS",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "147232",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "027540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brookfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.