Active NPI
Melissa Hubbard, PT
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1447377809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05007978A
- Practice address
- 6239 S East St Ste a
Indianapolis, IN 46227-2088 - Phone
- (317) 791-9031
- Fax
- (317) 791-9001
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 05007978A | IN | Primary |
Addresses
Primary practice location
6239 S East St Ste a
Indianapolis, IN 46227-2088
Mailing address
3866 Stonemeadow Dr
Greenwood, IN 46142-9440
Phone (317) 341-1479
Other practice location 1
4740 Kingsway Dr
Indianapolis, IN 46205-1521
Phone (317) 466-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100462120 | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05007978A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediplay LLC | 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.
-
- Occupational Therapist
- Indianapolis, IN
- NPI 1679695381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568678400000",
"number": "1447377809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3866 STONEMEADOW DR",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461429440",
"telephone_number": "317-341-1479",
"fax_number": "317-791-9001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6239 S EAST ST STE A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462272088",
"telephone_number": "317-791-9031",
"fax_number": "317-791-9001"
}
],
"practiceLocations": [
{
"address_1": "4740 Kingsway Dr",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462051521",
"country_code": "US",
"telephone_number": "317-466-1000",
"fax_number": "317-466-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUBBARD",
"first_name": "MELISSA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2019-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05007978A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100462120",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.