Individual provider Active NPI

Joshua Hubbard

  • General Practice Dentistry
  • Sumter, SC
National Provider Identifier
1225480049
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DGD.8743 GD Issued in SC
Practice address
1121 Broad St
Sumter, SC 29150-1902
Phone
(803) 883-0160
NPI assigned
Jul 5, 2016
Last updated
Jul 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DGD.8743 GD SC Primary

Addresses

Primary practice location

1121 Broad St
Sumter, SC 29150-1902

Mailing address

1121 Broad St
Sumter, SC 29150-1902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190507001815 SC Practitioner - Dentist 0648512913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DGD.8743 GDSCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc. Current Accepting new patients
Caresouth Carolina, Inc. CurrentSince Apr 1, 2019 Accepting new patients

Locations

545 Sumter Hwy
Bishopville, SC 29010
Phone (803) 484-5317

3080 Highway 15-401 E
Mc Coll, SC 29570
Phone (843) 523-5751

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1225480049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501902",
            "telephone_number": "803-883-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.8743 GD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.