KIM J HODGSON M.D. NPI 1417943937

NPI Information

NPI: 1417943937
Provider Name: KIM J HODGSON, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
340 W MILLER ST
SPRINGFIELD, IL
ZIP 62702
Phone: (217) 545-5555
Get Directions

Kim J Hodgson, M.D. is a vascular surgery surgery in Springfield, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Kim J Hodgson, M.D. NPI is 1417943937. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

340 W MILLER ST
SPRINGFIELD, IL
ZIP 62702-928
Phone: (217) 545-5555
Fax: (217) 545-2563

The NPI 1417943937 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2005 and was last updated on 10/16/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	036072794	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	C43767	MEDICARE UPIN
2	L60184	MEDICARE PIN	ILLINOIS
3	036072794	MEDICAID	ILLINOIS
4	256510	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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