Active NPI
Dennis Michael Hudson, MD
- Physical Medicine & Rehabilitation Physician
- Green Bay, WI
National Provider Identifier
1497771273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 34059
- Practice address
- 744 S Webster Ave
Green Bay, WI 54301-3505 - Phone
- (920) 433-3500
- Fax
- (920) 430-7114
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 34059 | WI | Primary |
Addresses
Primary practice location
744 S Webster Ave
Green Bay, WI 54301-3505
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
725 S Webster Ave
Green Bay, WI 54301-3500
Phone (920) 433-3655
Other practice location 2
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 735-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31203200 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34059 | WI | MD | Physical Medicine & Rehabilitation Physician |
Interoperability endpoints
- dhudson147315@direct.froedtert.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1497771273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013505",
"telephone_number": "920-433-3500",
"fax_number": "920-430-7114"
}
],
"practiceLocations": [
{
"address_1": "725 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013500",
"country_code": "US",
"telephone_number": "920-433-3655",
"fax_number": "920-433-3539",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "541532004",
"country_code": "US",
"telephone_number": "920-735-1100",
"fax_number": "920-835-1099",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUDSON",
"first_name": "DENNIS",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WI",
"license": "34059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31203200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.