Individual provider Active NPI

Meredith Marie Hudson, DDS

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1154412351
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00203765 Issued in CO
Practice address
7935 Constitution Ave Ste 110
Colorado Springs, CO 80951-8903
Phone
(719) 596-9668
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20203 TX
Dentist 122300000X DEN.00203765 CO Primary

Addresses

Primary practice location

7935 Constitution Ave Ste 110
Colorado Springs, CO 80951-8903

Mailing address

1631 Wetzel Ave
BLDG 815
Colorado Springs, CO 80913-4095
Phone (719) 526-5537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190920001411 CO Practitioner - Dentist 0840520631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20203TXMDProfessional Counselor
DEN.00203765COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 16, 2019 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 16, 2019 Accepting new patients

Locations

1815 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 344-6331

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

Interoperability endpoints

  • Direct secure messaging: meredith.hudson.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1154412351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 WETZEL AVE",
            "address_2": "BLDG 815",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809134095",
            "telephone_number": "719-526-5537",
            "fax_number": "719-524-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7935 CONSTITUTION AVE STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809518903",
            "telephone_number": "719-596-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "MEREDITH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20203",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.