Active NPI
Anne McClellan Hudson, PT
- Physical Therapist
- Monroe, NC
National Provider Identifier
1700053170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1523
- Practice address
- 701 E Roosevelt Blvd
Suite 600
Monroe, NC 28112-5170 - Phone
- (704) 289-4595
- Fax
- (704) 220-1005
- NPI assigned
- May 14, 2008
- Last updated
- Oct 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1523 | NC | Primary |
| Physical Therapist | 225100000X | 386 | SC |
Addresses
Primary practice location
701 E Roosevelt Blvd
Suite 600
Monroe, NC 28112-5170
Mailing address
PO Box 5001
Monroe, NC 28111-5001
Phone (704) 289-4595
Other names 1
- Anne McClellan Nicolay
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 386 | SC | MD | Clinical Psychologist |
| 1523 | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Bone & Joint PA | Past | Accepting new patients | |
| Carolina Bone & Joint PA | Physical Therapist | Past | Accepting new patients |
| Carolina Bone & Joint PA | Physical Therapist | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DAAICA
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rheumatology Physician
- Lancaster, SC
- NPI 1154484558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1700053170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5001",
"city": "MONROE",
"state": "NC",
"postal_code": "281115001",
"telephone_number": "704-289-4595",
"fax_number": "704-220-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E ROOSEVELT BLVD",
"address_2": "SUITE 600",
"city": "MONROE",
"state": "NC",
"postal_code": "281125170",
"telephone_number": "704-289-4595",
"fax_number": "704-220-1005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "ANNE",
"middle_name": "MCCLELLAN",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "1523",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "386",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNE",
"last_name": "NICOLAY",
"middle_name": "MCCLELLAN",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.