Stacie K. Hudson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2001033072 Issued in MO

Practice address

1901 E Hamilton St
Kirksville, MO 63501-3904

Phone

(660) 626-1400

Fax

(660) 665-3281

NPI assigned

Oct 16, 2007

Last updated

Oct 16, 2007By 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 1

Addresses

Other names 1

• Miss Stacie K. Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kirksville R-III Schools

  • Local Education Agency (LEA)
  • Kirksville, MO
  • NPI 1124163662
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1427247469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-626-1400",
            "fax_number": "660-665-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-626-1400",
            "fax_number": "660-665-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "STACIE",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2001033072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "JOHNSON",
            "middle_name": "K.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandon Hong
• Lauren J Horton, PLPC
• Hospice 2000, Inc. (Hospice of Northeast Missouri)
• Chase Edward Howerton
• Shelly Howerton, PTA
• Jamie Lynn Huffman, LPC
• Vanessa Huffmon
• Jessica Hunolt, PLCSW
• J. Paul Hunt, PH.D.
• Hattie Hunter

• Occupational Therapist in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Occupational Therapist in Missouri

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