Gregory Hudson MD Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GREGORY HUDSON MD INC

Doing business as

Christ Care Pediatrics

Practice address

137 State Route 3117
South Shore, KY 41175

Phone

(606) 932-2079

Fax

(606) 932-2313

NPI assigned

Nov 21, 2006

Last updated

Mar 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine Hunt

Title

Billing Credentialing

Phone

(606) 932-2079

Specialties & licenses 5

Addresses

Other identifiers 8

Other names 1

• CHRIST CARE PEDIATRICS Doing business as

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952476335. Details of each certification follow.

• CCN B03828 Rural health clinic · Active · Details

Rural health clinic certification: CCN B03828

Legal name

GREGORY HUDSON MD INC

Doing business as

CHRIST CARE PEDIATRICS

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 22, 2021

Last certification

Feb 22, 2021

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Jan 27, 1995 in OH

Enrollment address

137 State Route 3117
South Shore, KY 41175-9597

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Rachel M Hall, APRN

  • Nurse Practitioner
  • South Shore, KY
  • NPI 1376805143

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Gregory Hudson, MD

  • Pediatrics Physician
  • South Shore, KY
  • NPI 1245234277

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• William Andrew Ruggles, APRN

  • Nurse Practitioner
  • South Shore, KY
  • NPI 1750600870

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew G Hudson, MD

  • Pediatrics Physician
  • South Shore, KY
  • NPI 1457938938
  Medicare reassignment Care Compare group NPD
• Gregory Hudson, MD

  • Pediatrics Physician
  • South Shore, KY
  • NPI 1245234277
  Medicare reassignment Care Compare group
• William Andrew Ruggles, APRN

  • Nurse Practitioner
  • South Shore, KY
  • NPI 1750600870
  Medicare reassignment Care Compare group
• Samuel David Hudson, MD

  • Pediatrics Physician
  • South Shore, KY
  • NPI 1912560202
  Medicare reassignment NPD
• Rachel M Hall, APRN

  • Nurse Practitioner
  • South Shore, KY
  • NPI 1376805143
  Medicare reassignment

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1952476335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 STATE ROUTE 3117",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "41175",
            "telephone_number": "606-932-2079",
            "fax_number": "606-932-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 STATE ROUTE 3117",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "41175",
            "telephone_number": "606-932-2079",
            "fax_number": "606-932-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY HUDSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "BILLING CREDENTIALING",
        "authorized_official_telephone_number": "606-932-2079"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100724490",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "K182002",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D0683301",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243927",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433890",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D2062943",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100373950",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100373960",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRIST CARE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRIST CARE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Giggles & Gab Speech Therapy
• Amanda Gilliam
• Dorothy Luanne Gravely
• Greenup County Health Department
• Greenup County Health Dept
• Rachel M Hall, APRN
• Mary Elizabeth Hardy-Garcia, LPCC
• Heart EMS Inc
• Gregory Hudson, MD
• Matthew G Hudson, MD

• Rural Health Clinic/Center in South Shore, KY
• Providers in South Shore, KY by specialty
• Rural Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.