Teresa A Hodgson, PAC
Individual provider Active NPI Physician Assistant · Trenton, NE
NPI 1245375625 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245375625
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 720 (NE)
- Practice address
- 406 E 1St St
Trenton, NE 69044-1715 - Phone
- (308) 334-5155
- Fax
- (308) 334-5144
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240919004109 | NE | Practitioner - Physician Assistant | 9234391954 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital Association | Current |
Accepting new patients | |
| Community Hospital Association | Current |
Accepting new patients | |
| Community Hospital Association | Physician Assistant | Past | Accepting new patients |
Locations
1301 E H St
McCook, NE 69001
Phone (308) 344-2650
Interoperability endpoints
- teresahodgson@mccpc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 720 | NE | Yes |
Addresses
Primary practice location
406 E 1St St
Trenton, NE 69044-1715
Mailing address
307 Elizabeth LN
McCook, NE 69001-2228
Phone (308) 345-5696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38521 | Other | NE | BLUE CROSS |
Other providers in Trenton, NE
- Lacy Caddick
- Community Hospital Association
- Robin Cook
- Educational Service Unit 15
- Hitchcock County Schools #44-0070
- Desean Michael Jackson I
- Kristina Hope Kerst
- Trenton Nursing Home - Village of Trenton
- Hayley Sue Uerling
- Village of Trenton
All providers in Trenton, NE · Physician Assistant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.