Individual provider Active NPI

Michelle Hudleston, PA-C

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1346676574
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60351 Issued in CA
Practice address
3305 Placer St Ste B
Redding, CA 96001-2378
Phone
(530) 225-6805
Fax
(530) 262-6592
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60351 CA Primary

Addresses

Primary practice location

3305 Placer St Ste B
Redding, CA 96001-2378

Mailing address

1441 Liberty St
Redding, CA 96001-0811
Phone (530) 224-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230412002150 CA Practitioner - Physician Assistant 7810379658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redding RancheriaGroup PAC ID 7810969847, 32 clinicians

Practice addresses (Care Compare)

1441 Liberty St
Redding, CA 96001-0811
Phone 53022427001740

3305 Placer St
Suite B
Redding, CA 96001-2378
Phone (530) 225-6805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60351CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redding Rancheria Current Accepting new patients
Redding Rancheria CurrentSince Jun 25, 2023 Accepting new patients
Redding Rancheria CurrentSince Jun 25, 2023 Accepting new patients

Locations

3305 Placer St
Ste B
Redding, CA 96001
Phone (530) 225-6805

1441 Liberty St
Redding, CA 96001
Phone (530) 224-2700

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1346676574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010811",
            "telephone_number": "530-224-2700",
            "fax_number": "530-224-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 PLACER ST STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012378",
            "telephone_number": "530-225-6805",
            "fax_number": "530-262-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLESTON",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.