Individual provider Active NPI

Jaclyn Diane Hudnall, APRN, MSN, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1386351450
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114566 Issued in WV
Practice address
1249 15TH St Ste 2000
Huntington, WV 25701-3662
Phone
(304) 691-1000
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3018466 KY
Family Nurse Practitioner 363LF0000X 114566 WV Primary

Addresses

Primary practice location

1249 15TH St Ste 2000
Huntington, WV 25701-3662

Mailing address

1249 15TH St
Huntington, WV 25701-3662
Phone (304) 417-5422

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jaclyn.hudnall@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20230405002486 WV Practitioner - Nurse Practitioner 5698140655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1249 15TH St
Suite 2000
Huntington, WV 25701-3662
Phone (304) 691-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
3018466KYMDFamily Nurse Practitioner
114566WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Nov 12, 2024 Accepting new patients

Locations

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1249 15th St
Ste 2000
Huntington, WV 25701
Phone (304) 691-1086

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

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.

Hospital & facility affiliations 4

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": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1386351450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 15TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013662",
            "telephone_number": "304-417-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 15TH ST STE 2000",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013662",
            "telephone_number": "304-691-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDNALL",
        "first_name": "JACLYN",
        "middle_name": "DIANE",
        "credential": "APRN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3018466",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "114566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaclyn.hudnall@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1249 15th St Ste 2000",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.