Individual provider Active NPI

Mindi Hudek, LPN

  • Licensed Practical Nurse
  • Medford, OR
National Provider Identifier
1487118766
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201130583LPN Issued in OR
Practice address
1700 E Barnett Rd
Medford, OR 97504-0052
Phone
(541) 476-2373
NPI assigned
Jan 30, 2019
Last updated
May 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OR
Licensed Practical Nurse 164W00000X 201130583LPN OR Primary

Addresses

Primary practice location

1700 E Barnett Rd
Medford, OR 97504-0052

Mailing address

1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373

Other practice location 1

3156 State St
Medford, OR 97504-8450
Phone (541) 476-2373

Other practice location 2

1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201130583LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1487118766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975040052",
            "telephone_number": "541-476-2373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3156 State St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048450",
            "country_code": "US",
            "telephone_number": "541-476-2373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 SW G St",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975262544",
            "country_code": "US",
            "telephone_number": "541-476-2373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDEK",
        "first_name": "MINDI",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201130583LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.