Gunnar Hubbard, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE013401 Issued in PA

Practice address

1404 Golf Park Dr
Lake Ariel, PA 18436-4252

Phone

(570) 698-5647

Fax

(570) 698-7742

NPI assigned

Jun 21, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1891539185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 MEYLERT AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185092228",
            "telephone_number": "716-282-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 GOLF PARK DR",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184364252",
            "telephone_number": "570-698-5647",
            "fax_number": "570-698-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "GUNNAR",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE013401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Hess, PHARM D
• Rhonda Hicks
• Tammie Hinton, OTA/L,LMT
• Lisa A. Hood, RN
• Clair Anlee Hsiao, DMD
• Julia Ribaudo Healthcare Group, LLC (Julia Ribaudo Extended Care Center)
• Julia Ribaudo Senior Services, LLC (Brighten at Julia Ribaudo)
• Shristi Kharel
• David Korea, RPH
• Charles J Kovalchick, DO

• Physical Therapy Assistant in Lake Ariel, PA
• Providers in Lake Ariel, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.