MS. ROXANNE D. DUDLEY RN, PMHNP-BC, LPC
NPI 1922244904
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, TX

Q: What is Roxanne Dudley's NPI number?

The NPI number for Roxanne Dudley is 1922244904. It was assigned to this individual provider in the NPPES registry on December 23, 2008.

Q: What is Roxanne Dudley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Roxanne Dudley was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 23, 2008PECOS EnrolledAccepts Medicare Assignment

1011 COLLEGE AVE, JACKSONVILLE, TX 75766(903) 589-9000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Sep 14, 2017 (3 updates tracked since 2017).

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About Ms. Roxanne D. Dudley Rn, Pmhnp-bc, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ROXANNE D. DUDLEY RN, PMHNP-BC, LPC (NPI 1922244904) is an individual psychiatric/mental health provider in Jacksonville, Texas, licensed in Texas (AP134786) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922244904

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMS. ROXANNE D. DUDLEYCredential: RN, PMHNP-BC, LPC

Location Address1011 COLLEGE AVEJacksonville, TX 75766-3307

Mailing Address1011 College AveJacksonville, TX 75766-3307 · (512) 573-8026

Phone(903) 589-9000

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateDecember 23, 2008

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1922244904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in TX · AP134786

Also ListedCounselorTaxonomy 101Y00000X · License 62107 (TX)

1011 COLLEGE AVE, Jacksonville, TX 75766

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Secondary Practice Locations 2

Location 11405 S Fleishel Ave, Suite #332Tyler, TX 75701-3345 · Phone (512) 573-8026

Location 23320 S Loop 256Palestine, TX 75801-6984 · Phone (903) 723-6136

Other Identifiers 1

Medicaid1268237-08TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sendero Health Plans, Local Nonprofit.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Roxanne D. Dudley Rn, Pmhnp-bc, Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092072470

PECOS Enrollment IDI20171121001182

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75766 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAILA SUE RICE LPCI

Counselor (Mental Health)