Active NPI
Kody T Dudgeon
- Clinical Exercise Physiologist
- Amery, WI
National Provider Identifier
1417861220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- Practice address
- 265 Griffin St E
Amery, WI 54001-1439 - Phone
- (715) 268-0291
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | NU | Primary |
Addresses
Primary practice location
265 Griffin St E
Amery, WI 54001-1439
Mailing address
265 Griffin St E
Amery, WI 54001-1439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1417861220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 GRIFFIN ST E",
"city": "AMERY",
"state": "WI",
"postal_code": "540011439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 GRIFFIN ST E",
"city": "AMERY",
"state": "WI",
"postal_code": "540011439",
"telephone_number": "715-268-0291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDGEON",
"first_name": "KODY",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-29",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amery, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.