Active NPI
Deborah Hodge
- Contractor
- Orlando, FL
National Provider Identifier
1790108405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 7G331A/C
- Practice address
- 4001 Kaluga Park St
Orlando, FL 32808-7473 - Phone
- (407) 982-6629
- NPI assigned
- Jan 31, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 7G331A/C | FL | Primary |
Addresses
Primary practice location
4001 Kaluga Park St
Orlando, FL 32808-7473
Mailing address
4001 Kaluga Park St
Orlando, FL 32808-7473
Phone (407) 982-6629
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 684197096 | Other | FL | MEDWAIVER |
| 684197098 | Other | FL | MEDWAIVER |
| 6841970001 | Other | FL | MEDWAIVER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7G331A/C | FL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1790108405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 KALUGA PARK ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328087473",
"telephone_number": "407-982-6629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 KALUGA PARK ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328087473",
"telephone_number": "407-982-6629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-31",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "7G331A/C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDWAIVER",
"identifier": "684197096",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDWAIVER",
"identifier": "684197098",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDWAIVER",
"identifier": "6841970001",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.