Mishelle Bugtai Cubcuban

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

003929 Issued in WV

Practice address

298 Tricorn Rd
Danville, WV 25053-7148

Phone

(304) 369-1385

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Boone Memorial Homecare, LLC

  • Home Health Agency
  • Danville, WV
  • NPI 1184848970
  NPD

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1447972559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BEAR OAK LN UNIT 1",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253066390",
            "telephone_number": "304-601-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 TRICORN RD",
            "city": "DANVILLE",
            "state": "WV",
            "postal_code": "250537148",
            "telephone_number": "304-369-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBCUBAN",
        "first_name": "MISHELLE",
        "middle_name": "BUGTAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "003929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "298 Tricorn Rd",
            "city": "Danville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "250537148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Cox
• Caitlin Craddock
• Cheyenne Craddock
• Emily Cresong
• Amanda Crigger
• Mona Cullison
• Emily Paige Cummings
• Alicia Cyrus
• Valerie Dalton
• Danville Pharmacy LLC

• Physical Therapist in Danville, WV
• Providers in Danville, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.