Individual provider Active NPI

Kyle Hudson

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1801637335
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11033166 Issued in FL
Practice address
315 S Bonita Ave
Panama City, FL 32401-3961
Phone
(850) 832-2525
NPI assigned
Jun 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11033166 FL
Nurse Practitioner 363L00000X 11033166 FL
Certified Registered Nurse Anesthetist 367500000X 11033166 FL Primary

Addresses

Primary practice location

315 S Bonita Ave
Panama City, FL 32401-3961

Mailing address

315 S Bonita Ave
Panama City, FL 32401-3961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724000677 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193261360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Florida State University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Anesthesia Associates IncGroup PAC ID 0749273282, 16 clinicians
Anesthesia Physician Solutions of North Florida LLCGroup PAC ID 5597066001, 280 clinicians

Practice addresses (Care Compare)

3024 4TH St
Marianna, FL 32446-2125
Phone (850) 482-7200

4250 Hospital Dr
Marianna, FL 32446-1917
Phone (850) 482-7200

449 W 23Rd St
Panama City, FL 32405-4507
Phone (954) 939-5000

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11033166FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC Anesthesiology Current Accepting new patients
Jackson Anesthesia Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2024 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Anesthesiology CurrentSince Jun 3, 2024 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

3024 4th St
Marianna, FL 32446
Phone (850) 258-3148

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1801637335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013961",
            "telephone_number": "850-832-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "11033166",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11033166",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11033166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.