Amanda Kathlene Dixon Huddleston, MOT

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

1518 Issued in OK

Practice address

5052 W Waverly Rd
Fayetteville, AR 72704-6957

Phone

(918) 261-4023

NPI assigned

Jul 16, 2010

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

Other identifiers 2

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1265745418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 W WAVERLY RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046957",
            "telephone_number": "918-261-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5052 W WAVERLY RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046957",
            "telephone_number": "918-261-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "AMANDA",
        "middle_name": "KATHLENE DIXON",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "OK",
            "license": "1518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL BOARD",
            "identifier": "OTR2862",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION",
            "identifier": "1518",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ellen Hubbell, MD
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• Joanna Kay Hudec, D.C.
• Regina R Hudec, M.D.
• Wayne A Hudec, M.D.
• Hudgins Anesthesia
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• Physical Rehabilitation Occupational Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Rehabilitation Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.