Organization Active NPI

Hudson Mental Wellness Nurse Pract in Psych&Registered Prof Nurse PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dobbs Ferry, NY
National Provider Identifier
1437791258
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HUDSON MENTAL WELLNESS NURSE PRACT IN PSYCH&REGISTERED PROF NURSE PLLC
Practice address
145, Palisade St Ste 200
Dobbs Ferry, NY 10522
Phone
(484) 680-1355
NPI assigned
Oct 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Brigitte GordonNPI 1437590999
Title
Nurse Practitioner Psychiatry
Phone
(484) 680-1355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

145, Palisade St Ste 200
Dobbs Ferry, NY 10522

Mailing address

145, Palisade St Ste 200
Dobbs Ferry, NY 10522

Other identifiers 1

IdentifierTypeStateIssuer
401775OtherNYNY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260625000507 NY Part B Supplier - Clinic/Group Practice 1850864448 Receives reassigned benefits from 1 practitioner
Practice locations: Dobbs Ferry, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1437791258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145, PALISADE ST STE 200",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "10522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145, PALISADE ST STE 200",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "10522",
            "telephone_number": "484-680-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON MENTAL WELLNESS NURSE PRACT IN PSYCH&REGISTERED PROF NURSE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "BRIGITTE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER PSYCHIATRY",
        "authorized_official_telephone_number": "484-680-1355"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "401775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dobbs Ferry, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.