Individual provider Active NPI

Thomas Floyd Hudson III, MD

  • Dermatology Physician
  • Conway, AR
National Provider Identifier
1588643563
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R2661 Issued in AR
Practice address
9 Medical Lane
Conway, AR 72034
Phone
(501) 327-8480
Fax
(501) 327-2854
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X R2661 AR Primary

Addresses

Primary practice location

9 Medical Lane
Conway, AR 72034

Mailing address

9 Medical Lane
Conway, AR 72034
Phone (501) 327-8480

Other identifiers 1

IdentifierTypeStateIssuer
105042001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001568 AR Practitioner - Dermatology 1557555182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Baylor College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Medical Lane
Conway, AR 72034-4912

9 Medical LN
Conway, AR 72034-4912
Phone (501) 327-8480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1001
Removal or shaving of skin growth11
Skin biopsy426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2661ARMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tom Hudson LLC Dermatology CurrentSince Jun 10, 2002 Accepting new patients

Locations

9 Medical Ln
Conway, AR 72034
Phone (501) 327-2480

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1588643563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL LANE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-8480",
            "fax_number": "501-327-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL LANE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-8480",
            "fax_number": "501-327-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "THOMAS",
        "middle_name": "FLOYD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "R2661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105042001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.