Jocelyn Luedtke

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119010239 Issued in VA

Practice address

21750 Red Rum Dr Ste 117
Ashburn, VA 20147-5867

Phone

(703) 574-2989

NPI assigned

Dec 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cardinal Pediatric Therapy LLC

  • Occupational Therapist
  • Ashburn, VA
  • NPI 1841933595
  NPD

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1902294028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17302 SIMMONS RD",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201323529",
            "telephone_number": "402-689-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21750 RED RUM DR STE 117",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475867",
            "telephone_number": "703-574-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDTKE",
        "first_name": "JOCELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.