Individual provider Active NPI

Ernest Daisean Dubose, OTR/L

  • Occupational Therapist
  • Huntsville, AL
National Provider Identifier
1255214839
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6648 Issued in AL
Practice address
2061 Poole Dr NW
Huntsville, AL 35810-3843
Phone
(256) 975-0187
NPI assigned
Jul 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6648 AL Primary

Addresses

Primary practice location

2061 Poole Dr NW
Huntsville, AL 35810-3843

Mailing address

245 Cahaba Valley Pkwy Ste 200
Pelham, AL 35124-2217
Phone (205) 942-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813001222 AL Practitioner - Occupational Therapist in Private Practice 8325546864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed Orthopaedic SpecialistsGroup PAC ID 7214903723, 87 clinicians

Practice addresses (Care Compare)

33 Hughes Rd
Madison, AL 35758-2238
Phone (256) 464-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6648ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed Orthopaedic Specialists, PC CurrentSince Aug 6, 2025 Accepting new patients
Sportsmed Orthopaedic Specialists CurrentSince Aug 6, 2025 Accepting new patients

Locations

4715 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 319-8500

33 Hughes Rd
Madison, AL 35758
Phone (256) 319-9327

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1255214839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY STE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242217",
            "telephone_number": "205-942-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 POOLE DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358103843",
            "telephone_number": "256-975-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "ERNEST",
        "middle_name": "DAISEAN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "6648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.