Active NPI
Kristopher Thomas Hubbard, O.D.
- Optometrist
- Alliance, NE
National Provider Identifier
1467681122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1321
- Practice address
- 515 Niobrara Ave
Alliance, NE 69301-3421 - Phone
- (308) 762-3124
- Fax
- (308) 762-7326
- NPI assigned
- Jul 2, 2009
- Last updated
- Feb 4, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1321 | NE | Primary |
Addresses
Primary practice location
515 Niobrara Ave
Alliance, NE 69301-3421
Mailing address
PO Box 490
Alliance, NE 69301-0490
Phone (308) 762-3124
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06748 | Other | NE | BLUE CROSS BLUE SHIELD |
| 134259627 | Other | NE | RAILROAD MEDICARE GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1321 | NE | MD | Chiropractor |
Interoperability endpoints
- kristopher.hubbard.p2@direct.eyecenternoco.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Cheyenne, WY
- NPI 1720054802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1467681122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 490",
"city": "ALLIANCE",
"state": "NE",
"postal_code": "693010490",
"telephone_number": "308-762-3124",
"fax_number": "308-762-7326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 NIOBRARA AVE",
"city": "ALLIANCE",
"state": "NE",
"postal_code": "693013421",
"telephone_number": "308-762-3124",
"fax_number": "308-762-7326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "KRISTOPHER",
"middle_name": "THOMAS",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-02",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "1321",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "06748",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GA",
"identifier": "134259627",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alliance, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.