Brenna L Hudson, PA-C
Individual provider Active NPI Physician Assistant · Ray, ND
NPI 1497917397 · NPPES record last updated Jan 6, 2021
Key facts
- NPI
- 1497917397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAC0517 (ND)
- Practice address
- 10 Main St
Ray, ND 58849-4900 - Phone
- (701) 568-2796
- Fax
- (701) 568-5649
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6439 115TH Ave NW
Suite 2
Ray, ND 58849-9410
Phone (701) 568-2796
PO Box
Suite 798
Ray, ND 58849-0798
Hospital & facility affiliations
- CHI St Alexius Health Williston
- Tioga Medical Center
- Trinity Hospitals
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130717000401 | ND | Practitioner - Physician Assistant | 8820166937 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1176 | MN | MD | Marriage & Family Therapist |
| 10465 | MN | MD | Physical Therapist |
| PAC0517 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Home Care | Current |
Accepting new patients | |
| Mercy Hospital | Current |
Accepting new patients | |
| Cooperstown Medical Center | Current |
Accepting new patients | |
| Williston Radiology Consultants PC | Current |
Accepting new patients | |
| Cooperstown Medical Center | Current | Accepting new patients | |
| Cooperstown Medical Center | Current |
Accepting new patients |
Locations
107 12th St S
Cooperstown, ND 58425
Phone (701) 786-1700
1200 Roberts Ave NE
Cooperstown, ND 58425
Phone (701) 797-2128
570 Chautauqua Blvd
Valley City, ND 58072
Phone (701) 845-0440
3 4th St E
Apt 204
Williston, ND 58801
Phone (701) 572-6337
1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0517 | ND | Yes |
Addresses
Primary practice location
10 Main St
Ray, ND 58849-4900
Mailing address
PO Box 798
Ray, ND 58849-0798
Phone (701) 568-2796
Other practice location 1
311 South 5th Street
Drayton, ND 58225
Phone (218) 843-3612
Other names
- Brenna L Kerr
Other providers in Ray, ND
- Heidi L Barman
- Carrie A Burris
- Community Chiropractic Center
- Chelsie Haaland
- Melissa Margaret Miesaloski
- Anne-Louise Irene Morgan
- Northland Health Centers
- Northwest Therapy Services, LLC.
- Caitlin Olivia Olson
All providers in Ray, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.