Individual provider Active NPI

Taina Jausurawong Hudson

  • Pediatric Gastroenterology Physician
  • Overland Park, KS
National Provider Identifier
1972922698
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
2017013107 Issued in MO
Practice address
5808 W 110TH St
Overland Park, KS 66211-2504
Phone
(913) 696-8000
Fax
(816) 302-9939
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 93592 SC
Pediatric Gastroenterology Physician 2080P0206X 2017013107 MO Primary

Addresses

Primary practice location

5808 W 110TH St
Overland Park, KS 66211-2504

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other practice location 1

14 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6883
Phone (803) 434-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250407000904 SC Practitioner - Pediatric Medicine 7810411329 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93592SCMDAnesthesiology Physician
2017013107MOMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Apr 14, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 14, 2025 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

14 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 252-9907

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: thudson843081@direct.ghs.myhfn.org

Organizations & group practices 2

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1972922698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112504",
            "telephone_number": "913-696-8000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036883",
            "country_code": "US",
            "telephone_number": "803-434-8450",
            "fax_number": "803-434-0137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "TAINA",
        "middle_name": "JAUSURAWONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "SC",
            "license": "93592",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MO",
            "license": "2017013107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.