Individual provider Active NPI

Peter C Hubbard, RN, BSN

  • Emergency Registered Nurse
  • Tempe, AZ
National Provider Identifier
1003669128
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
RN155275 Issued in AZ
Practice address
1500 S Mill Ave
Tempe, AZ 85281-6699
Phone
(480) 784-5500
NPI assigned
Apr 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN155275 AZ Primary

Addresses

Primary practice location

1500 S Mill Ave
Tempe, AZ 85281-6699

Mailing address

2641 W Butler Dr Apt 1
Phoenix, AZ 85051-4147
Phone (480) 492-4434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN155275AZMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1003669128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 W BUTLER DR APT 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850514147",
            "telephone_number": "480-492-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MILL AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852816699",
            "telephone_number": "480-784-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "PETER",
        "middle_name": "C",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AZ",
            "license": "RN155275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.