Individual provider Active NPI

Stephen M Hudson, M.D.

  • Internal Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1154852861
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R4440 Issued in KY
Practice address
1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone
(859) 323-9918
Fax
(859) 323-1197
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.139101 OH
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X R4440 KY Primary

Addresses

Primary practice location

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other practice location 1

900 S Limestone Ctw 304
Lexington, KY 40536
Phone (859) 323-9918

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shudson737274@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220921001545 TX Practitioner - Internal Medicine 3779832258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bexar Physician Services, PLLCGroup PAC ID 6305298720, 23 clinicians

Practice addresses (Care Compare)

11212 State Hwy 151
San Antonio, TX 78251-4498
Phone (210) 703-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Bexar Physician Services, PLLC Single Specialty CurrentSince Dec 23, 2023 Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients
Uk Healthcare Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1154852861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "859-323-9918",
            "fax_number": "859-323-1197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 S Limestone Ctw 304",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-9918",
            "fax_number": "859-323-1197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.139101",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "R4440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shudson737274@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.