Individual provider Active NPI

Lisa A Hudson, WHNP-BC

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1437408606
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5115-33 Issued in WI
Practice address
3522 W Lisbon Ave
Milwaukee, WI 53208
Phone
(414) 935-8000
Fax
(414) 344-3396
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5115-33 WI Primary

Addresses

Primary practice location

3522 W Lisbon Ave
Milwaukee, WI 53208

Mailing address

PO Box 80257
Milwaukee, WI 53208-8004
Phone (414) 935-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20130925000377 WI Practitioner - Nurse Practitioner 5496999864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 N Mayfair Rd
FL 3
Wauwatosa, WI 53226-4216
Phone (414) 259-7480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5115-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Community Health Centers, Inc. CurrentSince Jun 25, 2013 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Nurse Practitioner CurrentSince Sep 30, 2019 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

1452 N 7th St
Fl 2
Milwaukee, WI 53205
Phone (414) 935-8000

3522 W Lisbon Ave
Milwaukee, WI 53208
Phone (414) 935-8000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Fl 3
Wauwatosa, WI 53226
Phone (414) 259-7480

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 2

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": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1437408606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80257",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532088004",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53208",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5115-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.