Organization Active NPI

Hubbard Bone & Joint Clinic LLC

  • Specialist
  • West Plains, MO
National Provider Identifier
1215028998
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
119275 Issued in MO
Legal business name
HUBBARD BONE & JOINT CLINIC LLC
Practice address
805 N Kentucky St
West Plains, MO 65775-2022
Phone
(417) 255-2063
Fax
(417) 255-2062
NPI assigned
Sep 27, 2006
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Mr. Dawn Gastineau
Title
Office Coordinator
Phone
(417) 255-2063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 119275 MO Primary

Addresses

Primary practice location

805 N Kentucky St
West Plains, MO 65775-2022

Mailing address

805 N Kentucky St
West Plains, MO 65775-2022
Phone (417) 255-2063

Other identifiers 2

IdentifierTypeStateIssuer
000014046OtherMEDICARE RR
244647806MedicaidMO

National Provider Directory

National Provider Directory

Locations

805 N Kentucky Ave
Ste 3
West Plains, MO 65775
Phone (417) 255-2063

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1215028998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N KENTUCKY ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752022",
            "telephone_number": "417-255-2063",
            "fax_number": "417-255-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N KENTUCKY ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752022",
            "telephone_number": "417-255-2063",
            "fax_number": "417-255-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUBBARD BONE & JOINT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "GASTINEAU",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "417-255-2063",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "119275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "000014046",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244647806",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.