Individual provider Active NPI

Jessica Lauren Carter, MSPT

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1790915940
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400047331 Issued in VT
Practice address
14901 Carey Rd
Carmel, IN 46033-6000
Phone
(877) 407-3422
NPI assigned
Jul 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0400047331 VT Primary

Addresses

Primary practice location

14901 Carey Rd
Carmel, IN 46033-6000

Mailing address

21 Essex Way
Suite 116
Essex Junction, VT 05452-3385
Phone (802) 879-8300

Other practice location 1

21 Essex Way
Suite 116
Essex Junction, VT 05452-3385
Phone (802) 879-8300

Other names 1

  • Miss Jessica Lauren Hubband Former name

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 Rehab Indiana LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122001585 IN Practitioner - Physical Therapist in Private Practice 0749329167 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0400047331VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Indiana LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients

Locations

14901 Carey Rd
Carmel, IN 46033

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1790915940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ESSEX WAY",
            "address_2": "SUITE 116",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523385",
            "telephone_number": "802-879-8300",
            "fax_number": "802-879-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 CAREY RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460336000",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Essex Way",
            "address_2": "Suite 116",
            "address_purpose": "LOCATION",
            "city": "Essex Junction",
            "state": "VT",
            "postal_code": "054523385",
            "country_code": "US",
            "telephone_number": "802-879-8300",
            "fax_number": "802-879-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JESSICA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400047331",
            "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 Rehab Indiana LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "14901 Carey Rd",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460336000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HUBBAND",
            "middle_name": "LAUREN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.