Individual provider Active NPI

Tory Gabrielle Houdek, OTD, OTR/L

  • Occupational Therapist
  • Mount Pleasant, WI
National Provider Identifier
1083488159
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8439-26 Issued in WI
Practice address
13203 Globe Dr Ste 111
Mount Pleasant, WI 53177-1616
Phone
(262) 287-0090
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8439-26 WI Primary

Addresses

Primary practice location

13203 Globe Dr Ste 111
Mount Pleasant, WI 53177-1616

Mailing address

13203 Globe Dr Ste 111
Mount Pleasant, WI 53177-1616
Phone (262) 287-0090

Other practice location 1

3615 Washington Rd
Kenosha, WI 53144-1640
Phone (262) 287-0090

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

LicenseStateTypeSpecialty
8439-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Support Services Inc CurrentSince Nov 12, 2023 Accepting new patients

Locations

3615 Washington Rd
Kenosha, WI 53144
Phone (262) 287-0090

13203 Globe Dr
Ste 111
Mount Pleasant, WI 53177
Phone (262) 287-0090

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1083488159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13203 GLOBE DR STE 111",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "531771616",
            "telephone_number": "262-287-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13203 GLOBE DR STE 111",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "531771616",
            "telephone_number": "262-287-0090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3615 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531441640",
            "country_code": "US",
            "telephone_number": "262-287-0090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUDEK",
        "first_name": "TORY",
        "middle_name": "GABRIELLE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8439-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.