Individual provider Active NPI

Angela Marie Hudson, ATC

  • Athletic Trainer
  • Dearborn, MI
National Provider Identifier
1124178066
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
2727 S Gulley Rd
Dearborn, MI 48124-3165
Phone
(313) 724-0352
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

2727 S Gulley Rd
Dearborn, MI 48124-3165

Mailing address

29143 Rosslyn Ave
Garden City, MI 48135-2769
Phone (734) 261-8687

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

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124178066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29143 ROSSLYN AVE",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352769",
            "telephone_number": "734-261-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 S GULLEY RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243165",
            "telephone_number": "313-724-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

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.

Verify at the official NPI Registry.