Individual provider Active NPI

Nelsy E Hudson, ARNP

  • Nurse Practitioner
  • Casselberry, FL
National Provider Identifier
1720490329
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9177916 Issued in FL
Practice address
985 State Road 436
Casselberry, FL 32707-5664
Phone
(407) 831-5252
Fax
(407) 831-3765
NPI assigned
May 30, 2014
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9177916 FL
Nurse Practitioner 363L00000X APRN9177916 FL Primary

Addresses

Primary practice location

985 State Road 436
Casselberry, FL 32707-5664

Mailing address

733 Minerva LN
Lake Mary, FL 32746-6410
Phone (321) 527-0913

Other identifiers 1

IdentifierTypeStateIssuer
012459500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140818002334 FL Practitioner - Nurse Practitioner 0648497461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

1299 E Commercial Blvd
Suite 201
Oakland Park, FL 33334-4806
Phone (720) 631-1142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9177916FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villagehealth DM LLC CurrentSince Aug 29, 2022 Accepting new patients
Central Florida Inpatient Medicine LLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746
Phone (407) 562-9170

1299 E Commercial Blvd
Ste 201
Oakland Park, FL 33334
Phone (720) 631-1142

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1720490329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 MINERVA LN",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466410",
            "telephone_number": "321-527-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 STATE ROAD 436",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075664",
            "telephone_number": "407-831-5252",
            "fax_number": "407-831-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "NELSY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-30",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9177916",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9177916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012459500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

Verify at the official NPI Registry.