Candice Marie Hudson, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

114776 Issued in MO

Practice address

13612 Big Bend Rd
Valley Park, MO 63088-1447

Phone

(314) 220-9830

Fax

(636) 825-2323

NPI assigned

Jul 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1134327562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 WILDWOOD DR",
            "city": "CEDAR HILL",
            "state": "MO",
            "postal_code": "630162117",
            "telephone_number": "314-220-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13612 BIG BEND RD",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630881447",
            "telephone_number": "314-220-9830",
            "fax_number": "636-825-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "114776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Lillmars-Stephens, FNP-C
• Mark Mandell, LPC, NCC, ME.D.
• Kathleen McCarthy

• Physical Therapist in Valley Park, MO
• Providers in Valley Park, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.