Individual provider Active NPI

Gary R Hudson

  • Pharmacist
  • Rochester, IN
National Provider Identifier
1265078083
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26015515A Issued in IN
Practice address
2040 Peace Tree VLG
Rochester, IN 46975-2630
Phone
(574) 223-6347
Fax
(574) 223-6618
NPI assigned
Nov 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26015515A IN Primary

Addresses

Primary practice location

2040 Peace Tree VLG
Rochester, IN 46975-2630

Mailing address

2040 Peace Tree VLG
Rochester, IN 46975-2630
Phone (574) 223-6347

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26015515AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I CurrentSince Apr 27, 2025 Accepting new patients
Kroger Limited Partnership I PastSince Dec 1, 2019 Accepting new patients

Locations

2040 Peace Tree Vlg
Rochester, IN 46975
Phone (574) 223-6347

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1265078083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 PEACE TREE VLG",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469752630",
            "telephone_number": "574-223-6347",
            "fax_number": "574-223-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 PEACE TREE VLG",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469752630",
            "telephone_number": "574-223-6347",
            "fax_number": "574-223-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26015515A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.