Individual provider Active NPI

Melissa Dawn Hudson, CRNA

  • Certified Registered Nurse Anesthetist
  • Gold Beach, OR
National Provider Identifier
1245476704
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
56338 Issued in ID
Practice address
94220 4TH St
Gold Beach, OR 97444-7756
Phone
(541) 247-3000
Fax
(541) 247-3104
NPI assigned
Jan 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60067579 WA
Certified Registered Nurse Anesthetist 367500000X 201704461CRNA OR
Certified Registered Nurse Anesthetist 367500000X 56338 ID Primary

Addresses

Primary practice location

94220 4TH St
Gold Beach, OR 97444-7756

Mailing address

94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000

Other practice location 1

406 S 30th Ave
Suite 202
Yakima, WA 98902-3713
Phone (509) 972-1051

Other identifiers 3

IdentifierTypeStateIssuer
1487696985OtherORCURRY HEALTH DISTRICT NPI
119263OtherORCURRY HEALTH DISTRICT MEDICAID
500688299MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090206000600 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022173053 Reassigns benefits to 2 organizations
I20171122001872 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022173053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River City Anesthesia Associates PLLCGroup PAC ID 4385534445, 22 clinicians

Practice addresses (Care Compare)

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
56338IDMDCertified Registered Nurse Anesthetist
201704461CRNAORMDCertified Registered Nurse Anesthetist
AP60067579WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
River City Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients
Anesthesia Associates of Coeur D Alene PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 19, 2015 Accepting new patients
Evergreen Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 13, 2017 Accepting new patients
Physician Anesthesia Assoc Inc PS PastSince Nov 21, 2016 Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

2121 W Ironwood Center Dr
Coeur D Alene, ID 83814
Phone (208) 625-4680

1581 E Edmondton Ave
Ste 204
Post Falls, ID 83854

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

1025 S 2nd Ave
Walla Walla, WA 99362
Phone (509) 525-0480

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1245476704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94220 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974447756",
            "telephone_number": "541-247-3000",
            "fax_number": "541-247-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94220 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974447756",
            "telephone_number": "541-247-3000",
            "fax_number": "541-247-3104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 S 30th Ave",
            "address_2": "SUITE 202",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023713",
            "country_code": "US",
            "telephone_number": "509-972-1051",
            "fax_number": "509-972-4166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60067579",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201704461CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "56338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY HEALTH DISTRICT NPI",
            "identifier": "1487696985",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY HEALTH DISTRICT MEDICAID",
            "identifier": "119263",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500688299",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Beach, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.