Jacquelyn Ludlam, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00537800 Issued in NJ

Practice address

5001 Statesman Dr
Irving, TX 75063-2414

Phone

(469) 524-1506

Fax

(972) 983-0267

NPI assigned

Jun 5, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1307232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1558655746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-444-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 STATESMAN DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632414",
            "telephone_number": "469-524-1506",
            "fax_number": "972-983-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLAM",
        "first_name": "JACQUELYN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-05",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114218",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00537800",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "277474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Lucas, M.ED., LPC
• Tonya Mischell Lucas, CPNP-PC
• Lucent Freight Services LLC
• Luciddx Labs, Inc
• Lucky Dental PLLC
• Ludwig Diversified Enterprises, Inc.
• Jude Lugari, RBT
• Lumin ER Partners, LLC
• Lumin Health Partners, PLLC
• Lumin Health Physician Group PA

• Occupational Therapist in Irving, TX
• Providers in Irving, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.