Active NPI
Norman Hubbard, RPT
- Physical Therapist
- Susanville, CA
National Provider Identifier
1427143031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 12628
- Practice address
- 711 Main St.
Susanville, CA 96130 - Phone
- (530) 257-8989
- Fax
- (530) 257-4649
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 12628 | CA | Primary |
Addresses
Primary practice location
711 Main St.
Susanville, CA 96130
Mailing address
711 Main St.
Susanville, CA 96130
Phone (530) 257-8989
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ41322Z | Other | CA | BLUE SHIELD OF CALIFORNIA |
| 00PT126280 | Other | CA | BLUE CROSS OF CALIFORNIA |
| 610626400 | Other | CA | O.W.C.P. / US DEPT OF LAB |
| 680442103 | Other | CA | TAX ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12628 | CA | MD | Optometrist |
| PT 12628 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Susanville Therapy Athletic Rehabilitation | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Susanville, CA
- NPI 1609087287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282867200000",
"number": "1427143031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 MAIN ST.",
"city": "SUSANVILLE",
"state": "CA",
"postal_code": "96130",
"telephone_number": "530-257-8989",
"fax_number": "530-257-4649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 MAIN ST.",
"city": "SUSANVILLE",
"state": "CA",
"postal_code": "96130",
"telephone_number": "530-257-8989",
"fax_number": "530-257-4649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "NORMAN",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2010-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 12628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CALIFORNIA",
"identifier": "ZZZ41322Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF CALIFORNIA",
"identifier": "00PT126280",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "O.W.C.P. / US DEPT OF LAB",
"identifier": "610626400",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "680442103",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Susanville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.