Active NPI
Heather Anne Hudson-Delap, RPA
- Physician Assistant
- Liverpool, NY
National Provider Identifier
1124193339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004755
- Practice address
- 8100 Oswego Road
Suite 220
Liverpool, NY 13090 - Phone
- (315) 652-6551
- Fax
- (315) 652-9698
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004755 | NY | Primary |
Addresses
Primary practice location
8100 Oswego Road
Suite 220
Liverpool, NY 13090
Mailing address
8100 Oswego Road
Suite 220
Liverpool, NY 13090
Phone (315) 652-6551
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000921861001 | Other | HEALTHNOW | |
| 351745 | Other | MVP HEALTHCARE |
Other names 1
- Heather Anne Hudson
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004755 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124193339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 OSWEGO ROAD",
"address_2": "SUITE 220",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "13090",
"telephone_number": "315-652-6551",
"fax_number": "315-652-9698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 OSWEGO ROAD",
"address_2": "SUITE 220",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "13090",
"telephone_number": "315-652-6551",
"fax_number": "315-652-9698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON-DELAP",
"first_name": "HEATHER",
"middle_name": "ANNE",
"credential": "RPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004755",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNOW",
"identifier": "000921861001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTHCARE",
"identifier": "351745",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "HUDSON",
"middle_name": "ANNE",
"credential": "RPA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Liverpool, NY
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.