Provider Demographics
NPI:1164812434
Name:HUGHES, MADISON (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD FALLS
Mailing Address - State:KS
Mailing Address - Zip Code:66845-9757
Mailing Address - Country:US
Mailing Address - Phone:316-214-4542
Mailing Address - Fax:
Practice Address - Street 1:3720 CHURCH ROCK ST
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4572
Practice Address - Country:US
Practice Address - Phone:316-214-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-04097224Z00000X
RIOT02273225X00000X
NMOT-2024-0183225X00000X
GAOT009044225X00000X
KS17-03512225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
22Medicare PIN