Jennifer Lynn Hudson, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0102202319 Issued in VA

Practice address

90 Hope Dr
366 Medical Group, Women'S Health
Mountain Home a F B, ID 83648-1057

Phone

(208) 282-7567

NPI assigned

Sep 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Wildflower OBGYN LLC

  • Obstetrics & Gynecology Physician
  • Boise, ID
  • NPI 1164300216
  Medicare reassignment NPD Authorized official
• Women'S Health Associates, PLLC

  • Obstetrics & Gynecology Physician
  • Boise, ID
  • NPI 1013957885
  Medicare reassignment NPD
• Glen S Lovelace MD PA

  • Specialist
  • Boise, ID
  • NPI 1023053204

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1265627319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "address_2": "366 MEDICAL GROUP, WOMEN'S HEALTH",
            "city": "MOUNTAIN HOME A F B",
            "state": "ID",
            "postal_code": "836481057",
            "telephone_number": "208-282-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "address_2": "366 MEDICAL GROUP, WOMEN'S HEALTH",
            "city": "MOUNTAIN HOME A F B",
            "state": "ID",
            "postal_code": "836481057",
            "telephone_number": "208-282-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "58-002420",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0102202319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Wade Cronin, LCSW
• Joe Cabalhin Dittman, IDMT
• Mary Dolores Dvorak, MD
• Omar D Hernandez Solano, IDMT
• Amy Jo Hicks
• Joseph Paul Keddie, IDMT
• Kristen Anne Lewis
• Dane A. Looman, IDMT
• Bonnie Lea Mack, CRNA
• Brandi Adele Mackey, IDMT

• Obstetrics & Gynecology Physician in Mountain Home a F B, ID
• Providers in Mountain Home a F B, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.