Active NPI
Amber Hubert, COTA
- Specialist
- Walnut Cove, NC
National Provider Identifier
1962623710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 03569
- Practice address
- 511 Windmill Street
Walnut Cove, NC 27052 - Phone
- (336) 591-4353
- NPI assigned
- May 1, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 03569 | OH | Primary |
Addresses
Primary practice location
511 Windmill Street
Walnut Cove, NC 27052
Mailing address
7429 Valley Meadows Drive
Fort Wayne, IN 46815
Phone (260) 515-6997
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03569 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962623710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7429 VALLEY MEADOWS DRIVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46815",
"telephone_number": "260-515-6997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 WINDMILL STREET",
"city": "WALNUT COVE",
"state": "NC",
"postal_code": "27052",
"telephone_number": "336-591-4353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBERT",
"first_name": "AMBER",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "03569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Cove, NC
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.