Hudson Primary Care PA
Organization Active NPI Primary Care Clinic/Center · Hudson, NC
NPI 1205923364 · NPPES record last updated Jun 22, 2009
Key facts
- NPI
- 1205923364
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 39973 (NC)
- Legal business name
- HUDSON PRIMARY CARE PA
- Practice address
- 109 Fairway Shopping Ctr
Hudson, NC 28638-2440 - Phone
- (828) 728-0900
- NPI assigned
- Oct 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard McBurney
- Title
- Practice Admin
- Phone
- (828) 728-0900
Corporate family (same tax ID) 1
Practitioners 3
-
Kirsten Jorgensen McBurney, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0693247 | Hudson Primary Care PA | Certificate of waiver | Apr 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120202000498 | NC | Part B Supplier - Clinic/Group Practice | 0345407342 |
Receives reassigned benefits from 3 practitioners Practice locations: Hudson, NC |
National Provider Directory
- Tax ID family
- Hudson Primary Care
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 39973 | NC | Yes |
Addresses
Primary practice location
109 Fairway Shopping Ctr
Hudson, NC 28638-2440
Mailing address
109 Fairway Shopping Ctr
Hudson, NC 28638-2440
Phone (828) 728-0900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7902528 | Medicaid | NC | |
| 5903060 | Medicaid | NC |
Other providers in Hudson, NC
- Hudson Discount Drug, Inc.
- Hudson Discount Drug, Inc.
- Hudson Discount Drug, Inc.
- Hudson Discount Drug, Inc.
- Hudson Discount Drugs, Inc.
- J. Tyron Barker DMD PA
- James W. Scheller Hudson
- Jems Healthcare Inc
- David Kays
- Kaley Kemp
All providers in Hudson, NC · Primary Care Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.