Individual provider Active NPI

Jessica L Hoback, PTA

  • Physical Therapy Assistant
  • Louisville, KY
National Provider Identifier
1407109176
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A02418 Issued in KY
Practice address
2141 Sycamore Avenue
Louisville, KY 40206
Phone
(502) 384-9052
Fax
(502) 384-9053
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A02418 KY Primary

Addresses

Primary practice location

2141 Sycamore Avenue
Louisville, KY 40206

Mailing address

2141 Sycamore Avenue
Louisville, KY 40206
Phone (502) 384-9052

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

LicenseStateTypeSpecialty
A02418KYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1407109176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 SYCAMORE AVENUE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40206",
            "telephone_number": "502-384-9052",
            "fax_number": "502-384-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 SYCAMORE AVENUE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40206",
            "telephone_number": "502-384-9052",
            "fax_number": "502-384-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBACK",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "A02418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.