Kimberly Shontae Hudson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

29547 Issued in TN

Practice address

1803 Union Ave
Memphis, TN 38104-3942

Phone

(901) 722-3152

NPI assigned

Aug 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Healthcare Community Care AssociatesGroup PAC ID 0941113757, shared by 2 NPIs, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khudson28503@mlh.direct-ci.com

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.

• Methodist Healthcare Community Care Associates

  • Urgent Care Clinic/Center
  • Cordova, TN
  • NPI 1194839241

  TN

  Medicare reassignment NPD
• Methodist Healthcare Community Care Associates

  • Urgent Care Clinic/Center
  • Olive Branch, MS
  • NPI 1821272501

  MS

  Medicare reassignment NPD
• Methodist Healthcare Community Care Associates

  • Urgent Care Clinic/Center
  • Memphis, TN
  • NPI 1326152455
  NPD
• Methodist Healthcare Community Care Associates

  • Corporate Health Clinic/Center
  • Memphis, TN
  • NPI 1699941195
  NPD

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

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1134895808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043942",
            "telephone_number": "901-722-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043942",
            "telephone_number": "901-722-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KIMBERLY",
        "middle_name": "SHONTAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-21",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Q Hudson, PHARM.D.
• Joseph Scott Hudson, MD
• Karen S Hudson, MA CCC SLP
• Keely Gene-Elaine Hudson
• Keri Lenore Hudson, DNP, FNP-C
• Marketa Hudson
• Melissa Maria Hudson, MD
• Moniqua Toquana Hudson, LPN
• Nikia Shauntreese Hudson, BS
• Rickey Hugh Hudson Sr., M.D.

• All providers in Memphis, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.