Provider Demographics
NPI:1598835720
Name:HUBBERSTEY, RHONDA A (PT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:A
Last Name:HUBBERSTEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:771 PILOT HOUSE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1990
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2302
Practice Address - Street 1:2106 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2402
Practice Address - Country:US
Practice Address - Phone:757-838-6678
Practice Address - Fax:757-838-8116
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009261225100000X
VA2305208598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00263401OtherRAILROAD MEDICARE PC
WA8939738OtherCRIME VICTIMS
WAP00264721OtherRAILROAD MED KING COUNTY
VA1598835720OtherMEDICAID QMB PROVIDER ID
WA8414773Medicaid
WA8026OWOtherREGENCE BLUE SHIELD
WA193238OtherDEPT OF LABOR & INDUSTRY
VAC05954OtherGROUP MEDICARE PTAN
WA8939738OtherCRIME VICTIMS
VA1598835720OtherMEDICAID QMB PROVIDER ID
WA8851178Medicare ID - Type UnspecifiedKING COUNTY