Lisa Jordan Hudson, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Caledonia, Mississippi. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Caledonia Community Clinic, Llc and her current practice location is
171 South St, Caledonia, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 855-0080.
Lisa Jordan Hudson is licensed to practice in Mississippi (license number 901828) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528577012.
Provider's Profile
| Full Name | Lisa Jordan Hudson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 8 Years |
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| Location | 171 South St, Caledonia, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Lisa Jordan Hudson graduated from nursing school in 2016
NPI Data:
- NPI Number: 1528577012
- Provider Enumeration Date: 09/27/2017
- Last Update Date: 05/21/2018
Medicare PECOS Information:
- PECOS PAC ID: 1456616259
- Enrollment ID: I20180529000617
Medical Identifiers
Medical identifiers for Lisa Jordan Hudson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528577012 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 901828 (Mississippi) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Caledonia Community Clinic, Llc | 8426466913 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Jordan Hudson allows following entities to bill medicare on her behalf.
| Entity Name | Caledonia Community Clinic, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619552130
PECOS PAC ID: 8426466913
Enrollment ID: O20210422000543 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Jordan Hudson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lisa Jordan Hudson, FNP-C
2294 Steens Vernon Rd,
Steens, MS 39766-9508
Ph: (662) 251-1433 | Lisa Jordan Hudson, FNP-C
171 South St,
Caledonia, MS 39740-8587
Ph: (662) 855-0080 |
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