Jody Ellen Goudreau, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1285 Issued in NH

Practice address

82 Barrett Rd
New London, NH 03257-5806

Phone

(603) 783-5530

NPI assigned

Dec 4, 2008

Last updated

Dec 4, 2008By the provider in NPPES

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

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1366687345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BARRETT RD",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575806",
            "telephone_number": "603-783-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 BARRETT RD",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575806",
            "telephone_number": "603-783-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDREAU",
        "first_name": "JODY",
        "middle_name": "ELLEN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "1285",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VT",
            "license": "0720000547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in New London, NH
• Providers in New London, NH by specialty
• Occupational Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.