Mackenci Hudiburg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2438 Issued in OK

Practice address

700 NE 13TH St
Oklahoma City, OK 73104-5004

Phone

(405) 271-4700

NPI assigned

Jan 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Questcare Em Oklahoma LLC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1427391481
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1255720355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 MONTCLAIR DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131764",
            "telephone_number": "405-488-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045004",
            "telephone_number": "405-271-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDIBURG",
        "first_name": "MACKENCI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarez Huddleston
• Hannah Katherine Hudgens
• Krystal E Hudgens, AUD., CCC-A
• Jacelyn Hudgins
• Katheren Hudgins, BA
• Blake Lee Hudson
• Brandy Nicole Hudson, MPT
• Chris Ryan Hudson
• Evan Christopher Hudson
• Jane Kay Hudson, MD

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.