Individual provider Active NPI

Kaitlyn Aubrey Hudson

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1861277329
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25393 Issued in FL
Practice address
484 Riverside Ave
Jacksonville, FL 32202-4912
Phone
(904) 579-2824
NPI assigned
Aug 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT25393 FL Primary

Addresses

Primary practice location

484 Riverside Ave
Jacksonville, FL 32202-4912

Mailing address

PO Box 932184
Atlanta, GA 31193-2184
Phone (856) 678-3484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MA, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230911002572 SC Practitioner - Occupational Therapist in Private Practice 9830553700 Reassigns benefits to 1 organization
I20240803000225 MA Practitioner - Occupational Therapist in Private Practice 9830553700 Reassigns benefits to 1 organization
I20241217002673 FL Practitioner - Occupational Therapist in Private Practice 9830553700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burke Collins Therapy, IncGroup PAC ID 8325231921, 11 clinicians

Practice addresses (Care Compare)

2808 Lithia Pinecrest Rd
Valrico, FL 33596-5611
Phone (904) 618-3778

3270 Tamaya Blvd
Jacksonville, FL 32246-0711
Phone (904) 618-3778

3339 Hwy 17
Green Cove Springs, FL 32043-3797
Phone (904) 618-3778

6280 Central Ave
Suite H2
St Petersburg, FL 33707-1429
Phone (800) 699-9395

8220 Natures Way
Apt 201
Lakewood Ranch, FL 34202-4208
Phone (800) 699-9395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT25393FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Collins Therapy, Inc CurrentSince Dec 1, 2024 Accepting new patients
H2 Rehabilitation Services of Florida LLC CurrentSince Dec 1, 2024 Accepting new patients
Fox Rehab Ma LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients
Burke Collins Therapy, Inc CurrentSince Sep 1, 2025 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Occupational Therapist CurrentSince Sep 1, 2023 Accepting new patients
H2 Rehabilitation Services of Florida LLC Current Accepting new patients

Locations

831 Santa Barbara Blvd
Ste 227
Cape Coral, FL 33991

3339 Highway 17
Green Cove Springs, FL 32043
Phone (904) 284-5721

484 Riverside Ave
Jacksonville, FL 32202
Phone (904) 579-2824

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1861277329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184",
            "telephone_number": "856-678-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024912",
            "telephone_number": "904-579-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KAITLYN",
        "middle_name": "AUBREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT25393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.