Individual provider Active NPI

Laura Jayne Hubbs, PA-C

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Norfolk, VA
National Provider Identifier
1417428715
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0110008625 Issued in VA
Practice address
6275 E Virginia Beach Blvd Ste 303
Norfolk, VA 23502-2851
Phone
(757) 461-3141
NPI assigned
Dec 12, 2018
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NJ
Medical Physician Assistant 363AM0700X 5174 CT
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0110008625 VA Primary

Addresses

Primary practice location

6275 E Virginia Beach Blvd Ste 303
Norfolk, VA 23502-2851

Mailing address

6275 E Virginia Beach Blvd Ste 303
Norfolk, VA 23502-2851
Phone (203) 688-4242

Other practice location 1

6275 E Virginia Beach Blvd Ste 303
Norfolk, VA 23502-2851
Phone (757) 461-3141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222002720 VA Practitioner - Physician Assistant 9133526882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5174CTMDSocial Worker
0110008625VAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1544572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1417428715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6275 E VIRGINIA BEACH BLVD STE 303",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022851",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6275 E VIRGINIA BEACH BLVD STE 303",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022851",
            "telephone_number": "757-461-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6275 E Virginia Beach Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235022851",
            "country_code": "US",
            "telephone_number": "757-461-3141",
            "fax_number": "757-461-1658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBS",
        "first_name": "LAURA",
        "middle_name": "JAYNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-12",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5174",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0110008625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.