Jerry Leroy Hubbard, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD11848 Issued in OR

Practice address

875 Oak St SE
Ste 5060
Salem, OR 97301-3987

Phone

(503) 399-1386

Fax

(503) 399-1182

NPI assigned

Jun 21, 2005

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1952307498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "STE 5060",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013987",
            "telephone_number": "503-399-1386",
            "fax_number": "503-399-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "STE 5060",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013987",
            "telephone_number": "503-399-1386",
            "fax_number": "503-399-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "JERRY",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD11848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118968",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Hu, D.M.D.
• Yibin Huang, LAC
• Tommy Huapeo Cuanas
• Jamie Malynn Hubbard-Parker, AUD
• Donald Hubbard II, MD
• Laurie Ann Hubbell-Smith, D.C.
• Vernon Troy Hubbell, B.S., D.C.
• Danyelle L Huber
• Kelsey Huber
• Lisa M Hublitz, RD, LD, CDE, CSP

• Neurological Surgery Physician in Salem, OR
• Providers in Salem, OR by specialty
• Neurological Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.