Individual provider Active NPI

Amy Rapp Hudson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1952362725
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E0836 Issued in AR
Practice address
1 Lile CT
Suite 101
Little Rock, AR 72205-6242
Phone
(501) 225-7711
Fax
(501) 225-7108
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E0836 AR Primary

Addresses

Primary practice location

1 Lile CT
Suite 101
Little Rock, AR 72205-6242

Mailing address

1 Lile CT
Suite 101
Little Rock, AR 72205-6242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000316 AR Practitioner - PathologyPractitioner - Dermatology 6901903855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Dermatology
Education
University of Mississippi School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Dermatology Clinic PLLCGroup PAC ID 4789688615, 11 clinicians

Practice addresses (Care Compare)

5921 Riley Park Dr
Fort Smith, AR 72916-6103
Phone (479) 649-3376

Merit-based Incentive Payment System (MIPS)

Final score
84.81 of 100Reported as group
Quality
82.93
Improvement activities
40
Cost
72.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0836ARMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Dermatology Clinic PLLC CurrentSince Oct 1, 2013 Accepting new patients
NPI 1275778219 Past Accepting new patients

Locations

5921 Riley Park Dr
Fort Smith, AR 72916
Phone (479) 649-3376

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1952362725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LILE CT",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LILE CT",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056242",
            "telephone_number": "501-225-7711",
            "fax_number": "501-225-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "AMY",
        "middle_name": "RAPP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E0836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.