Individual provider Active NPI

Sandra F Hubbard, CANP

  • Adult Health Nurse Practitioner
  • Slidell, LA
National Provider Identifier
1063682060
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP05326 Issued in LA
Practice address
2360 Gause Blvd E
Slidell, LA 70461-4141
Phone
(985) 641-7283
Fax
(985) 641-7218
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP05326 LA Primary

Addresses

Primary practice location

2360 Gause Blvd E
Slidell, LA 70461-4141

Mailing address

2360 Gause Blvd E
Slidell, LA 70461-4141
Phone (985) 641-7283

Other practice location 1

433 Plaza St Ste 514
Bogalusa, LA 70427-3729
Phone (985) 730-7023

Other identifiers 1

IdentifierTypeStateIssuer
2424599MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150904001180 LA Practitioner - Nurse Practitioner 9537475561 Reassigns benefits to 1 organization
I20151216000092 MS Practitioner - Nurse Practitioner 9537475561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12 Medical Plaza Blvd
Suite a
Picayune, MS 39466-9197
Phone (985) 641-7283

2360 Gause Blvd E
Suite E
Slidell, LA 70461-4141
Phone (985) 641-7283

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Adult Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Jefferson Physicians Group LLC CurrentSince Mar 1, 2023 Accepting new patients
Tchefuncte Cardiology Associates - Lakeview, LLC PastSince Mar 24, 2018 Accepting new patients
Metairie Physician Services Inc. Nurse Practitioner Past Accepting new patients

Locations

101 Judge Tanner Blvd
Ste 106
Covington, LA 70433
Phone (985) 867-2128

4228 Houma Blvd
Ste 530
Metairie, LA 70006
Phone (504) 456-8415

4320 Houma Blvd
Fl 6
Metairie, LA 70006
Phone (504) 503-4109

2360 Gause Blvd E
Ste E
Slidell, LA 70461
Phone (985) 641-7283

2360 Gause Blvd E
Slidell, LA 70461
Phone (504) 641-7283

12 Medical Plaza Blvd
#A
Picayune, MS 39466
Phone (985) 641-7283

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1063682060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614141",
            "telephone_number": "985-641-7283",
            "fax_number": "985-641-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614141",
            "telephone_number": "985-641-7283",
            "fax_number": "985-641-7218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 Plaza St Ste 514",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273729",
            "country_code": "US",
            "telephone_number": "985-730-7023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SANDRA",
        "middle_name": "F",
        "credential": "CANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP05326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2424599",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.