Active NPI
Courtney Hudson, MOTR/L
- Occupational Therapist
- Orange Park, FL
National Provider Identifier
1073986139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT15021
- Practice address
- 550 Wells Rd Ste 4
Orange Park, FL 32073-2950 - Phone
- (904) 278-7890
- NPI assigned
- Nov 10, 2015
- Last updated
- Nov 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT15021 | FL | Primary |
Addresses
Primary practice location
550 Wells Rd Ste 4
Orange Park, FL 32073-2950
Mailing address
1722 Moss Creek Dr
Fleming Island, FL 32003-8345
Phone (904) 629-1438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT15021 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Rehabilitation Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brooks Rehabilitation Hospital Bartram Campus
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1376114413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1073986139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 MOSS CREEK DR",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320038345",
"telephone_number": "904-629-1438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 WELLS RD STE 4",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320732950",
"telephone_number": "904-278-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "COURTNEY",
"name_prefix": "Mrs.",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-10",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT15021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.