Active NPI
Stephanie Corydon Hubbard, OD
- Optometrist
- University Park, FL
National Provider Identifier
1174009724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5573
- Practice address
- 5275 University Pkwy Unit 123
University Park, FL 34201-3013 - Phone
- (910) 850-9220
- NPI assigned
- Jul 17, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5573 | FL | Primary |
Addresses
Primary practice location
5275 University Pkwy Unit 123
University Park, FL 34201-3013
Mailing address
51 Pebble Beach PT
Sanford, NC 27332-0124
Phone (910) 850-9220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPC5573 | Other | FL | FLORIDA OPTOMETRY LICENSE |
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 |
|---|---|---|---|
| 5573 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1174009724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 PEBBLE BEACH PT",
"city": "SANFORD",
"state": "NC",
"postal_code": "273320124",
"telephone_number": "910-850-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5275 UNIVERSITY PKWY UNIT 123",
"city": "UNIVERSITY PARK",
"state": "FL",
"postal_code": "342013013",
"telephone_number": "910-850-9220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "STEPHANIE",
"middle_name": "CORYDON",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-17",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "5573",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA OPTOMETRY LICENSE",
"identifier": "OPC5573",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in University Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.