Individual provider Active NPI

Tanisha Salill Hudson

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1346935988
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-133299 Issued in AL
Practice address
3071 South Oates St
Dothan, AL 36301
Phone
(334) 500-5044
Fax
(334) 557-1054
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-133299 AL Primary

Addresses

Primary practice location

3071 South Oates St
Dothan, AL 36301

Mailing address

1500 1St Ave N Unit 3
Birmingham, AL 35203-1866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20230419000352 AL Practitioner - Nurse Practitioner 2264807510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Urgent Care LLCGroup PAC ID 8820305600, 171 clinicians

Practice addresses (Care Compare)

1026 S Eufaula Ave
Eufaula, AL 36027-2702
Phone (334) 689-4025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Mar 28, 2023 Accepting new patients
Rural Urgent Care LLC CurrentSince Mar 28, 2023 Accepting new patients

Locations

508 E Three Notch St
Ste 100
Andalusia, AL 36420
Phone (334) 362-2015

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

3071 S Oates St
Dothan, AL 36301
Phone (334) 500-5044

1026 S Eufaula Ave
Eufaula, AL 36027
Phone (334) 687-5775

Organizations & group practices 2

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1346935988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 SOUTH OATES ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-500-5044",
            "fax_number": "334-557-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "TANISHA",
        "middle_name": "SALILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-133299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.