Individual provider Active NPI

Giovanni Hudson

  • Behavior Technician
  • Pleasant Prairie, WI
National Provider Identifier
1093398778
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10450 72ND Ave
Pleasant Prairie, WI 53158-2911
Phone
(262) 657-6453
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-165849 IL
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

10450 72ND Ave
Pleasant Prairie, WI 53158-2911

Mailing address

1585 N Milwaukee Ave Ste 101
Libertyville, IL 60048-1359
Phone (847) 918-7947

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
RBT-21-165849ILMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. PastSince Mar 11, 2025 Accepting new patients
TJ Corporation I LLC PastSince Mar 11, 2025 Accepting new patients

Organizations & group practices 2

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1093398778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 N MILWAUKEE AVE STE 101",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481359",
            "telephone_number": "847-918-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 72ND AVE",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582911",
            "telephone_number": "262-657-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "GIOVANNI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-21-165849",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.