Individual provider Active NPI

Leah Hudelson, CNP

  • Family Nurse Practitioner
  • Dakota Dunes, SD
National Provider Identifier
1386489516
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP003252 Issued in SD
Practice address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone
(605) 217-2667
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R040253 SD
Family Nurse Practitioner 363LF0000X A180970 IA
Family Nurse Practitioner 363LF0000X CP003252 SD Primary

Addresses

Primary practice location

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312

Mailing address

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Other names 1

  • Leah Conover Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA, NE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240919001061 SD Practitioner - Nurse Practitioner 7416498357 Reassigns benefits to 1 organization
I20240920001153 IA Practitioner - Nurse Practitioner 7416498357 Reassigns benefits to 1 organization
I20250204002886 NE Practitioner - Nurse Practitioner 7416498357 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
Cnos PCGroup PAC ID 4284548942, 98 clinicians

Practice addresses (Care Compare)

201 E 4TH St
Suite 202
South Sioux City, NE 68776-9928
Phone (605) 217-2667

2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP003252SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cnos PC CurrentSince Sep 1, 2024 Accepting new patients
Cnos, PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

5708 Sunnybrook Ct
Sioux City, IA 51106

2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692

201 E 4th St
Ste 202
South Sioux City, NE 68776

1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800

575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615

Interoperability endpoints

  • Direct secure messaging: leahhudelson@cnos.allscriptsdirect.net

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 7

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": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1386489516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDELSON",
        "first_name": "LEAH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R040253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A180970",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP003252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "CONOVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dakota Dunes, SD

Sources for this page

Verify at the official NPI Registry.