Individual provider Active NPI

Willie Lee Hudson, APRN

  • Nurse Practitioner
  • The Villages, FL
National Provider Identifier
1265999890
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11001659 Issued in FL
Practice address
2910 Brownwood Blvd
The Villages, FL 32163-2032
Phone
(523) 674-1790
NPI assigned
Mar 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11001659 FL Primary

Addresses

Primary practice location

2910 Brownwood Blvd
The Villages, FL 32163-2032

Mailing address

1020 Lake Sumter LNDG
The Villages, FL 32162-2699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726000197 FL Practitioner - Nurse Practitioner 3678809712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

8550 NE 138TH LN
Suite 502
Lady Lake, FL 32159-6804
Phone (352) 810-3536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11001659FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pophealthcare, LLC CurrentSince Oct 20, 2024 Accepting new patients
Sage Infusion, LLC CurrentSince Jan 5, 2023 Accepting new patients
Pophealthcare, LLC Nurse Practitioner CurrentSince Oct 20, 2024 Accepting new patients

Locations

8880 Gladiolus Dr
Ste C200
Fort Myers, FL 33908
Phone (239) 533-5962

1090 NW 8th Ave
Ste 30
Gainesville, FL 32601
Phone (352) 450-8886

10739 Deerwood Park Blvd
Ste 200
Jacksonville, FL 32256
Phone (615) 721-7024

8550 NE 138th Ln
Ste 502
Lady Lake, FL 32159
Phone (352) 810-3536

2191 9th Ave N
Ste 105
St Petersburg, FL 33713
Phone (727) 209-1419

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

113 Seaboard Ln
Ste 200B
Franklin, TN 37067
Phone (615) 721-7020

Organizations & group practices 3

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": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1265999890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LAKE SUMTER LNDG",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321622699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632032",
            "telephone_number": "523-674-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "WILLIE",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11001659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.