Kelly A Hudock, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

VP006579B Issued in PA

Practice address

1605 N Cedar Crest Blvd Ste 110B
Allentown, PA 18104-2351

Phone

(610) 973-1410

Fax

(610) 973-1442

NPI assigned

May 1, 2006

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rosenfeld Vanwirt PC

  • Internal Medicine Physician
  • Center Valley, PA
  • NPI 1629402680
  Medicare reassignment NPD
• HCR Manor Care Medical Services of Florida LLC

  dba Heartland Care Partners

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1881861052
  NPD
• HCR Manorcare Medical Services of Florida LLC

  dba Heartland Care Partners

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420

  Family Medicine

  NPD

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1639137771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351",
            "telephone_number": "610-973-1410",
            "fax_number": "610-973-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDOCK",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NN095449NJ",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "VP006579B",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "VP006579B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2318736",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "223733353",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8440506",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Huber, RN
• Michelle R Huber, CRNA
• Stephen J. Huber, M.D.
• Charles E. Huckel, CRNA
• Jacinta M Hudak
• Heather Hudson, CW021505
• Vincent J. Hudson, DPT
• Shelly Huff
• Hugh J Odonnell Jr DDS PC Pediatric Dentistry
• Bryn Hughes

• Family Nurse Practitioner in Allentown, PA
• Providers in Allentown, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.