Individual provider Active NPI

Monte Wayne Hudson, D.C.

  • Chiropractor
  • Granbury, TX
National Provider Identifier
1457337198
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4673 Issued in TX
Practice address
1920 Acton Hwy
Granbury, TX 76049-5988
Phone
(817) 579-0178
Fax
(817) 573-0441
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4673 TX Primary

Addresses

Primary practice location

1920 Acton Hwy
Granbury, TX 76049-5988

Mailing address

1920 Acton Hwy
Granbury, TX 76049-5988
Phone (817) 579-0178

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110106001234 TX Practitioner - Chiropractic 5496833436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1920 Acton Hwy
Granbury, TX 76049-5988
Phone (817) 579-0178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4673TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Granbury Chiropractic Center Chiropractor CurrentSince Dec 3, 1991 Accepting new patients
Lake Granbury Chiropractic Ctr. Chiropractor CurrentSince Dec 3, 1991 Accepting new patients

Locations

1920 Acton Hwy
Granbury, TX 76049
Phone (254) 968-4600

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.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1457337198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 ACTON HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760495988",
            "telephone_number": "817-579-0178",
            "fax_number": "817-573-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ACTON HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760495988",
            "telephone_number": "817-579-0178",
            "fax_number": "817-573-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "MONTE",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.