Individual provider Active NPI

Robin Rae Hudson

  • Pediatrics Physician
  • Bentonville, AR
National Provider Identifier
1396987772
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-7441 Issued in AR
Practice address
2719 SE I St
Bentonville, AR 72712-3996
Phone
(479) 273-5437
Fax
(479) 273-9932
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-7441 AR Primary

Addresses

Primary practice location

2719 SE I St
Bentonville, AR 72712-3996

Mailing address

2719 SE I Street
Bentonville, AR 72712

Other identifiers 1

IdentifierTypeStateIssuer
193450001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010001111 SC Practitioner - Pediatric Medicine 0143727537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Arkansas College of Medicine, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Poston Rd
Charleston, SC 29407-3428

PO Box
Suite 421718
Georgetown, SC 29442

PO Box
Suite 421718
Georgetown, SC 29442-4203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-7441ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Physician Associates LLC Pediatrics CurrentSince Sep 22, 2025 Accepting new patients
Georgetown Physician Associates, LLC Current Accepting new patients
Georgetown Physician Associates, LLC Pediatrics CurrentSince Sep 22, 2025 Accepting new patients
Bentonville Pediatrics Pediatrics Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Northwest Arkansas Immunization Pediatrics Past Accepting new patients
Georgetown Physician Services, LLC Past Accepting new patients

Locations

2347 S Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-2443

4320 Holmestown Rd
Myrtle Beach, SC 29588
Phone (843) 546-3132

12117 Ocean Hwy
Pawleys Island, SC 29585
Phone (843) 237-8231

Interoperability endpoints

  • Direct secure messaging: livingtreepediatrics.robinhudson@132911.advancedmd-direct.com

Organizations & group practices 7

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1396987772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 SE I STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 SE I ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123996",
            "telephone_number": "479-273-5437",
            "fax_number": "479-273-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ROBIN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193450001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.