Active NPI
Nicole Marie Hudson, DO
- Student in an Organized Health Care Education/Training Program
- Louisville, KY
National Provider Identifier
1821784463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 530 S Jackson St # C1H17
Louisville, KY 40202-1675 - Phone
- (502) 852-5689
- Fax
- (502) 852-0066
- NPI assigned
- Apr 17, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
530 S Jackson St # C1H17
Louisville, KY 40202-1675
Mailing address
530 S Jackson St # C1H17
Louisville, KY 40202-1675
Phone (502) 852-5689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240917002695 | KY | Order and Referring Only - Emergency Medicine | 2163963208 |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Marian University College of Osteopathic Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Zotec Way
Carmel, IN 46032-0052
11460 N Meridian St
Carmel, IN 46032-4530
PO Box
Suite 1547
Middletown, OH 45042
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681689600000",
"number": "1821784463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 S JACKSON ST # C1H17",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021675",
"telephone_number": "502-852-5689",
"fax_number": "502-852-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 S JACKSON ST # C1H17",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021675",
"telephone_number": "502-852-5689",
"fax_number": "502-852-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-17",
"last_updated": "2023-04-17",
"certification_date": "2023-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.
- 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.