Individual provider Active NPI

Nicole Hudson, OTR/L

  • Occupational Therapist
  • Cape Coral, FL
National Provider Identifier
1124497177
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17301 Issued in FL
Practice address
2328 Hancock Bridge Pkwy Ste 103
Cape Coral, FL 33990-1455
Phone
(239) 574-7557
Fax
(239) 574-1315
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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 OT17301 FL Primary

Addresses

Primary practice location

2328 Hancock Bridge Pkwy Ste 103
Cape Coral, FL 33990-1455

Mailing address

2328 Hancock Bridge Pkwy
Suite 103
Cape Coral, FL 33990-1459
Phone (239) 573-1518

Other identifiers 1

IdentifierTypeStateIssuer
68-6520OtherFLMEDICARE GROUP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT17301FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Specialty & Rehabilitation Center Inc Occupational Therapist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1124497177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 HANCOCK BRIDGE PKWY",
            "address_2": "SUITE 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901459",
            "telephone_number": "239-573-1518",
            "fax_number": "239-573-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 HANCOCK BRIDGE PKWY STE 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901455",
            "telephone_number": "239-574-7557",
            "fax_number": "239-574-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "68-6520",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.