Individual provider Active NPI

Bonnie Walker Hudson, FNP-C

  • Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1669931028
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
J5011593 Issued in NC
Practice address
1000 Brabham Ave
Jacksonville, NC 28546-5003
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
Mar 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X HUDS-7L88M5 NC
Nurse Practitioner 363L00000X J5011593 NC Primary

Addresses

Primary practice location

1000 Brabham Ave
Jacksonville, NC 28546-5003

Mailing address

1000 Brabham Ave
Jacksonville, NC 28546-5003
Phone (910) 341-3300

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190702002133 NC Practitioner - Nurse Practitioner 7911231519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1000 Brabham LN
Jacksonville, NC 28546-5003
Phone (910) 341-1540

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Hospital & facility affiliations

  • Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
J5011593NCMDNurse Practitioner
HUDS-7L88M5NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Health PLLC Current Accepting new patients
Wilmington ASC LLC CurrentSince Feb 10, 2020 Accepting new patients
Wilmington Health PLLC CurrentSince Feb 10, 2020 Accepting new patients

Locations

1000 Brabham Ave
Jacksonville, NC 28546
Phone (910) 347-1515

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Interoperability endpoints

  • Direct secure messaging: bonnie.hudson.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 3

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 2

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": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1669931028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BRABHAM AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465003",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRABHAM AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465003",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "BONNIE",
        "middle_name": "WALKER",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "HUDS-7L88M5",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "J5011593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.