Jaclyn Hudson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17-04080 Issued in KS

Practice address

721 Metropolitan Ave Ste C
Leavenworth, KS 66048-1403

Phone

(913) 250-5452

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Deborah a King Ma & Associates Inc

  • Speech-Language Pathologist
  • Shawnee Mission, KS
  • NPI 1942408950
  NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1154047587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 HUNT RD",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660271406",
            "telephone_number": "719-352-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 METROPOLITAN AVE STE C",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481403",
            "telephone_number": "913-250-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JACLYN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "480015",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-04080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kye Marie Howard
• Lillian Anne Howell, LCP
• Diana Howlett, RN
• Alice Hsu, M.D.
• Dawn Rishelle Hudson, RN
• Shannon Sharai' Hudson, LMSW
• Lorree Huffman, PA
• Kathleen Hund, RN
• Paul Eugene Hund, D.D.S
• Daniaell M Hupp Murphy, R.PH.

• Occupational Therapist in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Occupational Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.