Reuben Guy Hudson, MD FAAP

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

7161277 Issued in ID

Practice address

305 E Jefferson St
Boise, ID 83712-6231

Phone

(208) 381-6196

Fax

(208) 381-6199

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Urology

  NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - Trinity Mountain

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1710995295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E JEFFERSON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126231",
            "telephone_number": "208-381-6196",
            "fax_number": "208-381-6199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Madison St Ste 800",
            "address_2": "Swedish Pediatric Specialist Clinic",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041306",
            "country_code": "US",
            "telephone_number": "206-215-2700",
            "fax_number": "206-215-2702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "REUBEN",
        "middle_name": "GUY",
        "credential": "MD FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "ID",
            "license": "7161277",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD25800",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00048852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213391",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8425738",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonelle Hudson, APRN-CNP
• Kambrielle Alissa Hudson, MSW
• Kayla Hudson, LMSW
• Kevin M Hudson, PA-C
• Kieler Hudson
• Randall Steven Hudspeth, NP
• Brooke Hueftle
• Steven Scott Huerd, M.D.
• Jennifer Huff
• Timothy Jayson Huff, D.D.S.

• Pediatric Urology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Urology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.