NPIMap

Organization Active NPI

Hubbell Dermatology and Aesthetics a Professional Medical Corporation

  • Specialist
  • Lafayette, LA
National Provider Identifier
1811038433
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
019067 Issued in LA
Legal business name
HUBBELL DERMATOLOGY AND AESTHETICS A PROFESSIONAL MEDICAL CORPORATION
Practice address
309 Settlers Trace Blvd
Ste 100
Lafayette, LA 70508-3062
Phone
(337) 981-6065
Fax
(337) 981-6066
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Dr. Christopher Raymond Hubbell, MDNPI 1720030091
Title
Physician
Phone
(337) 981-6065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 019067 LA Primary

Addresses

Primary practice location

309 Settlers Trace Blvd
Ste 100
Lafayette, LA 70508-3062

Mailing address

309 Settlers Trace Blvd
Ste 100
Lafayette, LA 70508-3062
Phone (337) 981-6065

Other names 1

  • Acadiana Dermatology Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chubbell@directaddress.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070524000026 LA Part B Supplier - Clinic/Group Practice 2365442456 Receives reassigned benefits from 5 practitioners
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

309 Settlers Trace Blvd
#100
Lafayette, LA 70508
Phone (337) 981-6065

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1811038433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SETTLERS TRACE BLVD",
            "address_2": "STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083062",
            "telephone_number": "337-981-6065",
            "fax_number": "337-981-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SETTLERS TRACE BLVD",
            "address_2": "STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083062",
            "telephone_number": "337-981-6065",
            "fax_number": "337-981-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUBBELL DERMATOLOGY AND AESTHETICS A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "HUBBELL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-981-6065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "019067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chubbell@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "309 Settlers Trace Blvd",
            "address_2": "Ste 100",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705083062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Acadiana Dermatology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.