Kadija Yvette Hudson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2404 Ferrand St Ste 23
Monroe, LA 71201-3233

Phone

(318) 323-0463

Fax

(318) 323-0465

NPI assigned

Dec 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Immanuels Healing Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, LA
  • NPI 1043472608
  NPD (past)

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1629616743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 FERRAND ST STE 23",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013233",
            "telephone_number": "318-323-0463",
            "fax_number": "318-323-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 FERRAND ST STE 23",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013233",
            "telephone_number": "318-323-0463",
            "fax_number": "318-323-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KADIJA",
        "middle_name": "YVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4701066",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lynn Howell, MD
• Ronald Collins Hubbard Sr., M.D.
• Toya Hubbard
• Bruce Wallace Huber
• Eva Hudson
• Loretta June Hudson
• Loria Hudson
• Madison Hudson
• Retieka Hudson
• Brooke Roberts Huff

• Case Manager/Care Coordinator in Monroe, LA
• Providers in Monroe, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.