Staci Lea Hudson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902167 Issued in MS

Practice address

2705 Hwy 51 South
Hernando, MS 38632

Phone

(662) 449-1971

NPI assigned

Jul 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Staci Lea Lush Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Mississippi School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Medicare reassignment Care Compare group NPD
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  Medicare reassignment NPD
• MDB Behavioral Health Services LLC

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Care Compare group
• Region IV Desoto County Pharmacy

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572739200000",
    "number": "1851814875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HWY 51 SOUTH",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "38632",
            "telephone_number": "662-449-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HWY 51 SOUTH",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "38632",
            "telephone_number": "662-449-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "STACI",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2019-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "LUSH",
            "middle_name": "LEA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Tiffany Houston, FNP-C
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• In Focus Psychiatry LLC
• Abigail Isbell, DPT

• Psychiatric/Mental Health Nurse Practitioner in Hernando, MS
• Providers in Hernando, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2019; 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.

Verify at the official NPI Registry.