Active NPI
Enoch Amani Hudson
- Driver
- Rockford, MN
National Provider Identifier
1689394074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 5950 Oak St
Rockford, MN 55373-9498 - Phone
- (651) 444-0434
- NPI assigned
- Aug 29, 2022
- Last updated
- Aug 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | NU | Primary |
Addresses
Primary practice location
5950 Oak St
Rockford, MN 55373-9498
Mailing address
5950 Oak St
Rockford, MN 55373-9498
Phone (651) 444-0434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1689394074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5950 OAK ST",
"city": "ROCKFORD",
"state": "MN",
"postal_code": "553739498",
"telephone_number": "651-444-0434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5950 OAK ST",
"city": "ROCKFORD",
"state": "MN",
"postal_code": "553739498",
"telephone_number": "651-444-0434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "ENOCH",
"middle_name": "AMANI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.