Individual provider Active NPI

Peggy A. Hudson, PH.D.

  • Psychologist
  • Oklahoma City, OK
National Provider Identifier
1578670857
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1036 Issued in OK
Practice address
921 NE 13TH St # 116a
Oklahoma City VA Medical Center
Oklahoma City, OK 73104-5007
Phone
(405) 456-5183
Fax
(405) 456-1523
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1036 OK Primary
Counseling Psychologist 103TC1900X 1036 OK

Addresses

Primary practice location

921 NE 13TH St # 116a
Oklahoma City VA Medical Center
Oklahoma City, OK 73104-5007

Mailing address

921 NE 13TH St # 116a
Oklahoma City VA Medical Center
Oklahoma City, OK 73104-5007
Phone (405) 456-5183

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1036OKMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1578670857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST # 116A",
            "address_2": "OKLAHOMA CITY VA MEDICAL CENTER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-456-5183",
            "fax_number": "405-456-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST # 116A",
            "address_2": "OKLAHOMA CITY VA MEDICAL CENTER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-456-5183",
            "fax_number": "405-456-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "PEGGY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1036",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OK",
            "license": "1036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.