NPIMap

Individual provider Active NPI

Jared A Hudson, MD

  • Anesthesiology Physician
  • Bristol, TN
National Provider Identifier
1699271759
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
64583 Issued in TN
Practice address
350 Blountville Hwy Ste 207
Bristol, TN 37620-1671
Phone
(423) 968-4540
Fax
(423) 968-5697
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 64583 TN Primary

Addresses

Primary practice location

350 Blountville Hwy Ste 207
Bristol, TN 37620-1671

Mailing address

350 Blountville Hwy Ste 207
Bristol, TN 37620-1671
Phone (423) 968-4540

Other practice location 1

625 19th Street South
Birmingham, AL 35249-6810
Phone (205) 934-4696

Other practice location 2

500 22nd St S
Birmingham, AL 35233-3110
Phone (800) 822-8816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721003458 TN Practitioner - Anesthesiology 0941555692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
East Tennessee State University Quillen College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Aug 1, 2022 Accepting new patients
Paragon Anesthesia PC Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Singing River Health System Past Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

Locations

350 Blountville Hwy
Ste 207
Bristol, TN 37620
Phone (423) 968-2772

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

Organizations & group practices 4

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 7

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1699271759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY STE 207",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201671",
            "telephone_number": "423-968-4540",
            "fax_number": "423-968-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY STE 207",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201671",
            "telephone_number": "423-968-4540",
            "fax_number": "423-968-5697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th Street South",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352496810",
            "country_code": "US",
            "telephone_number": "205-934-4696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 22nd St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352333110",
            "country_code": "US",
            "telephone_number": "800-822-8816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JARED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "64583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.