Caleb Ian Hudson, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.005518 Issued in IL

Practice address

201 Lafayette Ave E
Mattoon, IL 61938-4641

Phone

(217) 235-5449

NPI assigned

Jan 29, 2021

Last updated

Jan 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1821689217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAFAYETTE AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384641",
            "telephone_number": "217-235-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "CALEB",
        "middle_name": "IAN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Hrvol, A.D.N.
• HSHS Medical Group Inc (HSHS Medical Group Multispecialty Care - Mattoon)
• Debra L Huddleston, LCPC
• Megan Huddleston
• Ashley Nicole Huddlestun, FNP-BC
• Emily Hudson, BA
• Morgan Huffman, BS
• Christine Hughes, LPC
• Jennifer Lynn Hughes
• Barbara Hunter, OTRL, CHT, CEAS

• Occupational Therapy Assistant in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.