Individual provider Active NPI

Erica Jade Hudson

  • Speech-Language Pathologist
  • Riverview, FL
National Provider Identifier
1699182980
Registry record updated Dec 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA13105 Issued in FL
Practice address
10821 Boyette Rd
Riverview, FL 33569-8012
Phone
(813) 461-5405
NPI assigned
Jul 18, 2014
Last updated
Dec 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA13105 FL Primary

Addresses

Primary practice location

10821 Boyette Rd
Riverview, FL 33569-8012

Mailing address

9808 Cristina Dr
Riverview, FL 33569-5501
Phone (813) 461-5405

Other identifiers 1

IdentifierTypeStateIssuer
104451500MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
SA13105FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidmunication, LLC CurrentSince Mar 3, 2024 Accepting new patients

Locations

10821 Boyette Rd
Riverview, FL 33569
Phone (786) 302-3403

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1699182980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 CRISTINA DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695501",
            "telephone_number": "813-461-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698012",
            "telephone_number": "813-461-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ERICA",
        "middle_name": "JADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104451500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; 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.