Active NPI
Theresa Marjorie Hudson, MD
- Family Medicine Physician
- Newnan, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 147556
- Practice address
- 2700 Highway 34 E
BLDG 300
Newnan, GA 30265-2315 - Phone
- (770) 304-0987
- Fax
- (770) 251-0938
- NPI assigned
- Jan 23, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 039594 | GA | |
| Family Medicine Physician | 207Q00000X | 147556 | CA | Primary |
Addresses
Primary practice location
2700 Highway 34 E
BLDG 300
Newnan, GA 30265-2315
Mailing address
2700 Highway 34 E
BLDG 300
Newnan, GA 30265-2315
Phone (770) 304-0987
Other practice location 1
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000708045C | Medicaid | GA |
Other names 1
- Dr. Theresa Perry Hudson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147556 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Family Medicine | Current | Accepting new patients |
| The Fort Defiance Indian Hospital Board, Incorporation | Current | Accepting new patients | |
| Piedmont Providers LLC | Past | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
6875 Douglas Blvd
Ste A
Douglasville, GA 30135
Phone (404) 379-6148
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
Family Medicine
-
dba Fort Defiance Indian Hospital
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1477876639
TX
-
- Internal Medicine Physician
- Jasper, GA
- NPI 1548273592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1790839983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 HIGHWAY 34 E",
"address_2": "BLDG 300",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302652315",
"telephone_number": "770-304-0987",
"fax_number": "770-251-0938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 HIGHWAY 34 E",
"address_2": "BLDG 300",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302652315",
"telephone_number": "770-304-0987",
"fax_number": "770-251-0938"
}
],
"practiceLocations": [
{
"address_1": "Corner of Route N12 and N7",
"address_purpose": "LOCATION",
"city": "Fort Defiance",
"state": "AZ",
"postal_code": "865040649",
"country_code": "US",
"telephone_number": "928-729-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUDSON",
"first_name": "THERESA",
"middle_name": "MARJORIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2025-03-17",
"certification_date": "2025-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "039594",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "147556",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000708045C",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6875 Douglas Blvd Ste A",
"city": "Douglasville",
"state": "GA",
"country_code": "US",
"postal_code": "301357155",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "THERESA",
"last_name": "HUDSON",
"middle_name": "PERRY",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.