Individual provider Active NPI

Angela K Hudson, CRNA

  • Certified Registered Nurse Anesthetist
  • Marietta, GA
National Provider Identifier
1326336140
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN193279 Issued in GA
Practice address
2540 Windy Hill Rd SE
Marietta, GA 30067
Phone
(470) 644-1274
Fax
(470) 644-1119
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN193279 GA Primary

Addresses

Primary practice location

2540 Windy Hill Rd SE
Marietta, GA 30067

Mailing address

2540 Windy Hill Rd SE
Marietta, GA 30067-8605

Other practice location 1

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 838-8710

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahudson534102@directwellstar.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110831000628 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335319276 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical College of Georgia School of Medicine, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN193279GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 15, 2023 Accepting new patients
TMC-West Georgia Anesthesia Associates Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 9, 2011 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

Organizations & group practices 4

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 1

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1326336140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30067",
            "telephone_number": "470-644-1274",
            "fax_number": "470-644-1119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Dixie St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173818",
            "country_code": "US",
            "telephone_number": "770-838-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ANGELA",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN193279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahudson534102@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2540 Windy Hill Rd SE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.