Shannon Christine Hudson, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

47149 Buse Rd
Unit #1370
Patuxent River, MD 20670-1540

Phone

(301) 342-1429

NPI assigned

Mar 15, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1992774640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 GUM WAY",
            "address_2": "APT C",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206532288",
            "telephone_number": "301-342-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47149 BUSE RD",
            "address_2": "UNIT #1370",
            "city": "PATUXENT RIVER",
            "state": "MD",
            "postal_code": "206701540",
            "telephone_number": "301-342-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "SHANNON",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT DUTY CORPSMAN",
            "identifier": "1710I1002X",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Grove, PH.D.
• Kelly M. Harvey
• Christopher Demarcus Hawkins, I.D.C.
• Heather Denise Henderson
• William Anthony Hill, RN, OD
• Saqib Muhammad Ishteeaque, DMD
• Leslie Ann Jago, PHARMD.
• Rebecca Lea Kong, PHARM D
• Ellen Jane Lesh, MD
• Kirtney So Lim, IDC

• Independent Duty Corpsman in Patuxent River, MD
• Providers in Patuxent River, MD by specialty
• Independent Duty Corpsman in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.