Active NPI
Jacqueline Celeste Hodge, MD
- Diagnostic Radiology Physician
- Irving, TX
National Provider Identifier
1205035607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 171821
- Practice address
- 5001 Statesman Dr
C/O Staffcare, Inc.
Irving, TX 75063-2414 - Phone
- (800) 685-2272
- Fax
- (972) 983-0254
- NPI assigned
- Jul 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 171821 | NY | Primary |
Addresses
Primary practice location
5001 Statesman Dr
C/O Staffcare, Inc.
Irving, TX 75063-2414
Mailing address
Porzellangasse 19/2/1
Vienna, VIENNA 1090
AT
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171821 | Other | NY | MEDICAL LICENSE |
| 2005025948 | Other | MO | MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Diagnostic Radiology | Past | Accepting new patients |
| Advanced Imaging & Radiology of Lenox Hill Hospital PC | Diagnostic Radiology | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1740364314
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Diagnostic Radiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1205035607",
"addresses": [
{
"country_code": "AT",
"country_name": "Austria",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "PORZELLANGASSE 19/2/1",
"city": "VIENNA",
"state": "VIENNA",
"postal_code": "1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 STATESMAN DR",
"address_2": "C/O STAFFCARE, INC.",
"city": "IRVING",
"state": "TX",
"postal_code": "750632414",
"telephone_number": "800-685-2272",
"fax_number": "972-983-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "JACQUELINE",
"middle_name": "CELESTE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-16",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "171821",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "171821",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "2005025948",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.