Kim J Hodgson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

036072794 Issued in IL

Practice address

340 W Miller St
Springfield, IL 62702-4928

Phone

(217) 545-5555

Fax

(217) 545-2563

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kimhodgson@siusm.allscriptsdirect.net

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.

• Board of Trustees of Southern Illinois University

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1417943937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19638",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949638",
            "telephone_number": "217-545-5555",
            "fax_number": "217-545-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W MILLER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024928",
            "telephone_number": "217-545-5555",
            "fax_number": "217-545-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "KIM",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036072794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072794",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha L Hlafka, M.D.
• Sheena R Hoadley, MSN, FNP
• Anne Lunt Hocking, NP
• Mark C Hodel, CRNA
• Rachelle Hodel, FNP
• Rachel Hodo, FNP-BC
• Cari Lynn Hoedebecke
• Ava Hoeft
• Kaneisha Hoehn
• Jeanette Ayotte Hoelzer, LCPC

• Vascular Surgery Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Vascular Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.