Robert Clint Hudson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1576 Issued in MS

Practice address

103 Medical Park
Hattiesburg, MS 39401-9042

Phone

(601) 268-5757

Fax

(601) 579-5220

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chudson11076@directpatientrecord.com

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1821102740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEDICAL PARK",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394019042",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ROBERT",
        "middle_name": "CLINT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572OK",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03533751",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chudson11076@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "103 Medical Park",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394019042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Helen Rachael Gandy Hudson, DO
• Jack G Hudson, MD
• Jana Maria Hudson, MSN, FNP-C
• Janet Hudson, RD
• Jeffrey L Hudson, MD
• Sarah Marie Hudson, DO
• Steven Matthew Hudson, PHARM.D.
• Thomas Neil Hudson, FNP
• Christopher Thomas Hudspeth, DO
• Hugger Home Care Services LLC

• Physical Therapist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.