Individual provider Active NPI

Timothy J. Huberty, PTA

  • Physical Therapy Assistant
  • Phoenix, AZ
National Provider Identifier
1457776932
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10022A Issued in AZ
Practice address
1907 W Camelback Rd
Phoenix, AZ 85015-3439
Phone
(602) 285-0949
Fax
(602) 285-0052
NPI assigned
Feb 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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 10022A AZ Primary

Addresses

Primary practice location

1907 W Camelback Rd
Phoenix, AZ 85015-3439

Mailing address

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260-6279
Phone (480) 551-4961

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
10022AAZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1457776932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE",
            "address_2": "STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606279",
            "telephone_number": "480-551-4961",
            "fax_number": "480-860-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153439",
            "telephone_number": "602-285-0949",
            "fax_number": "602-285-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERTY",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "10022A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.