Active NPI
Joseph C Hudson, MD
- Aerospace Medicine Physician
- Nellis AFB, NV
National Provider Identifier
1346406766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- 63702
- Practice address
- 4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600 - Phone
- (702) 404-1142
- NPI assigned
- Aug 5, 2008
- Last updated
- Nov 1, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 63702 | GA | Primary |
Addresses
Primary practice location
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Mailing address
4700 Las Vegas Blvd N
Nellis AFB, NV 89191
Phone (702) 404-1142
Other practice location 1
Psc 41 Box 230
Apo, AE 09464-0003
Phone 011441638528852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160225002441 | SD | Order and Referring Only - General Practice | 9830494038 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63702 | GA | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509494400000",
"number": "1346406766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "89191",
"telephone_number": "702-404-1142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-404-1142"
}
],
"practiceLocations": [
{
"address_1": "Psc 41 Box 230",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AE",
"postal_code": "094640003",
"country_code": "US",
"telephone_number": "011441638528852",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "HUDSON",
"first_name": "JOSEPH",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-05",
"last_updated": "2017-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "GA",
"license": "63702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nellis AFB, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.