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NPI 1164396610ActiveOrganization· PACE Provider Organization· Douglasville, GA
PACE Provider Organization in Douglasville, Georgia, registered in NPPES in September 2025, part of Keshia Hudson. The authorized official on file is Keshia Hudson, Business.
Overview
| NPI | 1164396610 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Keshia Hudson |
| NPI issued | Sep 30, 2025 |
| Last updated in NPPES | Sep 30, 2025 |
| Certified by provider | Sep 29, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|