Individual provider Active NPI

Anthony Charles Hudson

  • Pediatrics Physician
  • Metairie, LA
National Provider Identifier
1144595455
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
207837 Issued in LA
Practice address
4740 S I 10 Service Rd W FL 2
Metairie, LA 70001-1234
Phone
(504) 883-3703
Fax
(504) 833-3704
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 207837 LA Primary

Addresses

Primary practice location

4740 S I 10 Service Rd W FL 2
Metairie, LA 70001-1234

Mailing address

1813 Auburn Ave
Metairie, LA 70003-3631
Phone (504) 813-7642

Other practice location 1

372 Tudor Ave.
River Ridge, LA 70123
Phone (504) 813-7642

Other identifiers 1

IdentifierTypeStateIssuer
2192892MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200330000200 LA Practitioner - Pediatric Medicine 4082917455 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207837LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Dec 16, 2019 Accepting new patients
Children'S Hospital Pediatrics Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

4740 S I 10 Service Rd W
Fl 2
Metairie, LA 70001
Phone (504) 883-3703

4845 Veterans Memorial Blvd
Metairie, LA 70006

4845 Veterans Memorial Blvd
#48
Metairie, LA 70006
Phone (504) 883-3703

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 3

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1144595455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 AUBURN AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700033631",
            "telephone_number": "504-813-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 S I 10 SERVICE RD W FL 2",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011234",
            "telephone_number": "504-883-3703",
            "fax_number": "504-833-3704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "372 Tudor Ave.",
            "address_purpose": "LOCATION",
            "city": "River Ridge",
            "state": "LA",
            "postal_code": "70123",
            "country_code": "US",
            "telephone_number": "504-813-7642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ANTHONY",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "207837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2192892",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.