Active NPI
Van S Hubbard, M.D.
- Pediatrics Physician
- Bethesda, MD
National Provider Identifier
1871694018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 22612
- Practice address
- 6707 Democracy Blvd
Room 631
Bethesda, MD 20892-0001 - Phone
- (301) 594-8827
- Fax
- (301) 480-3768
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 22612 | MN | Primary |
Addresses
Primary practice location
6707 Democracy Blvd
Room 631
Bethesda, MD 20892-0001
Mailing address
5022 Acacia Ave
Bethesda, MD 20814-2890
Phone (301) 897-5799
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22612 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871694018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5022 ACACIA AVE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142890",
"telephone_number": "301-897-5799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6707 DEMOCRACY BLVD",
"address_2": "ROOM 631",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208920001",
"telephone_number": "301-594-8827",
"fax_number": "301-480-3768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "VAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "22612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.