Joshua Blake Dubose, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA04882 Issued in TX

Practice address

4015 Interstate 45 N
Conroe, TX 77304-4901

Phone

(936) 756-6631

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Sadler Clinic Association

  • Multi-Specialty Clinic/Center
  • Conroe, TX
  • NPI 1114979127
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1700997665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-756-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044901",
            "telephone_number": "936-756-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "JOSHUA",
        "middle_name": "BLAKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188072603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise Petra Dreyer, OTR
• Claudia A Driscoll
• Holly Driscoll
• Jenice Angelle Dubard, PMHNP-BC
• Lauren Beth Dubner, DO
• Rachael Lee Duckett
• Duffey Therapy Group PLLC
• Andrea Nichole Dulworth, OTR
• Shannen Nicole Dumadag
• Elizabeth Duncan

• Medical Physician Assistant in Conroe, TX
• Providers in Conroe, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.

Verify at the official NPI Registry.