Active NPI
Judith Lorraine Souther, OTR
- Occupational Therapist
- Hudson, WI
National Provider Identifier
1497889794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4141
- Practice address
- 2705 Enloe St
Hudson, WI 54016-8173 - Phone
- (715) 386-2128
- Fax
- (715) 386-6119
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4141 | WI | Primary |
Addresses
Primary practice location
2705 Enloe St
Hudson, WI 54016-8173
Mailing address
1511 Branston St
Saint Paul, MN 55108-1437
Phone (651) 644-4086
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40872200 | Medicaid | WI | |
| 7689529 | Other | AETNA | |
| 641671046996 | Other | PREFERRED ONE | |
| 98G59SO | Other | BCBS MN | |
| HP43837 | Other | HEALTH PARTNERS | |
| 6404305 | Other | MEDICA |
Other names 1
- Judith Lorraine Simon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4141 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1497889794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 BRANSTON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551081437",
"telephone_number": "651-644-4086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 ENLOE ST",
"city": "HUDSON",
"state": "WI",
"postal_code": "540168173",
"telephone_number": "715-386-2128",
"fax_number": "715-386-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHER",
"first_name": "JUDITH",
"middle_name": "LORRAINE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "4141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40872200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7689529",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "641671046996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "98G59SO",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP43837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6404305",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JUDITH",
"last_name": "SIMON",
"middle_name": "LORRAINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.