Evan Hubbard

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-1187 Issued in NM

Practice address

1011 A 10TH Street
Alamogordo, NM 88310

Phone

(575) 439-9878

Fax

(575) 439-9876

NPI assigned

Oct 29, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Back in Action Therapy LLC

  • Physical Therapist
  • Alamogordo, NM
  • NPI 1043386188
  NPD (past)

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1891167854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 CEDAR CREEK PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203874",
            "telephone_number": "575-439-9878",
            "fax_number": "575-439-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 A 10TH STREET",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "88310",
            "telephone_number": "575-439-9878",
            "fax_number": "575-439-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-1187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "A-1187",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele La Vonne Horrell, RIC
• Jeronne Howard Jr.
• Charles Wesley Hoyt, LPC
• Dan Robert Hoyt, PT
• Matthew A Hoyt, DPT
• Ashley Dawn Hudson, LMSW
• David Allen Hudson
• Nikolas Huffman
• Brittany Nicole Huggins
• Hughes Anesthesia LLC

• Physical Therapy Assistant in Alamogordo, NM
• Providers in Alamogordo, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.