Individual provider Active NPI

Kimberlee Joanna Hudgins

  • Physical Therapist
  • Amarillo, TX
National Provider Identifier
1619265477
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1208809 Issued in TX
Practice address
6204 Hillside Rd
Suite 1000
Amarillo, TX 79109-7196
Phone
(806) 355-7633
Fax
(806) 355-7644
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1208809 TX Primary

Addresses

Primary practice location

6204 Hillside Rd
Suite 1000
Amarillo, TX 79109-7196

Mailing address

6204 Hillside Rd
Suite 1000
Amarillo, TX 79109-7196
Phone (806) 355-7633

Other identifiers 2

IdentifierTypeStateIssuer
149984001MedicaidTX
207164901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130717000681 TX Practitioner - Physical Therapist in Private Practice 9032359906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Rehabilitation of Texas LLCGroup PAC ID 6608275607, 4 clinicians

Practice addresses (Care Compare)

1510 S Van Buren St
Amarillo, TX 79101-4130
Phone (806) 337-4000

1511 S Van Buren St
Amarillo, TX 79101-4129
Phone (806) 803-9777

400 SW 14TH Ave
Amarillo, TX 79101-4140
Phone (806) 337-5177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Century Rehabilitation of Texas LLC Physical Therapist CurrentSince May 17, 2024 Accepting new patients
Optimal Physical Therapy Solutions, LLC Physical Therapist CurrentSince Feb 7, 2011 Accepting new patients

Locations

4703 Bluebonnet Blvd
Baton Rouge, LA 70809
Phone (225) 661-2222

6204 Hillside Rd
Ste 1000
Amarillo, TX 79109
Phone (806) 355-7633

1510 S Van Buren St
Amarillo, TX 79101
Phone (806) 337-4000

6801 Bell St
Ste 1400
Amarillo, TX 79109
Phone (806) 355-7633

7710 Hillside Rd
Ste 600
Amarillo, TX 79119
Phone (806) 355-7633

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1619265477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6204 HILLSIDE RD",
            "address_2": "SUITE 1000",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791097196",
            "telephone_number": "806-355-7633",
            "fax_number": "806-355-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6204 HILLSIDE RD",
            "address_2": "SUITE 1000",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791097196",
            "telephone_number": "806-355-7633",
            "fax_number": "806-355-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDGINS",
        "first_name": "KIMBERLEE",
        "middle_name": "JOANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1208809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.