Individual provider Active NPI

Elizabeth Carrie Hubbucks, OTR/L

  • Occupational Therapist
  • Haverford, PA
National Provider Identifier
1639319874
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004743 Issued in OH
Practice address
551 W Lancaster Ave
Haverford, PA 19041-1419
Phone
(610) 525-4000
NPI assigned
Feb 28, 2009
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 004743 OH Primary

Addresses

Primary practice location

551 W Lancaster Ave
Haverford, PA 19041-1419

Mailing address

43 Landings Way
Avon Lake, OH 44012-2248
Phone (440) 240-3040

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services OH, LLC

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

LicenseStateTypeSpecialty
004743OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Therapy, LLC CurrentSince Jun 7, 2013 Accepting new patients

Locations

3044 Highway 17 Byp N
#B
Mt Pleasant, SC 29466
Phone (843) 881-2030

3409 Salterbeck St
#202
Mt Pleasant, SC 29466
Phone (843) 216-6800

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.

NPI Registry JSON

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1639319874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 LANDINGS WAY",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122248",
            "telephone_number": "440-240-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 W LANCASTER AVE",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411419",
            "telephone_number": "610-525-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBUCKS",
        "first_name": "ELIZABETH",
        "middle_name": "CARRIE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-28",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "004743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services OH, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "5531 Chappell Crossing Blvd",
            "city": "West Chester",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450695226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Haverford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.