Active NPI
Victoria Hubbell, PTA
- Physical Therapy Assistant
- Liberty, MO
National Provider Identifier
1043087877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2020034833
- Practice address
- 102 S Forrest Ave
Liberty, MO 64068-1908 - Phone
- (816) 492-5199
- NPI assigned
- Dec 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2020034833 | MO | Primary |
| Physical Therapy Assistant | 225200000X | 14-03767 | KS |
Addresses
Primary practice location
102 S Forrest Ave
Liberty, MO 64068-1908
Mailing address
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6338
Other practice location 1
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6338
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-03767 | KS | MD | Physical Therapy Assistant |
| 2020034833 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1043087877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 POPE AVE",
"city": "FORT LEAVENWORTH",
"state": "KS",
"postal_code": "660272332",
"telephone_number": "913-684-6338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S FORREST AVE",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640681908",
"telephone_number": "816-492-5199"
}
],
"practiceLocations": [
{
"address_1": "550 Pope Ave",
"address_purpose": "LOCATION",
"city": "Fort Leavenworth",
"state": "KS",
"postal_code": "660272332",
"country_code": "US",
"telephone_number": "913-684-6338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUBBELL",
"first_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-12",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2020034833",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-03767",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.