1598628745 NPI number — BRADLEY W HOBBS RN

Table of content: BRADLEY W HOBBS RN (NPI 1598628745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598628745 NPI number — BRADLEY W HOBBS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOBBS
Provider First Name:
BRADLEY
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598628745
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11361 N 99TH AVE STE 402
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85345-5459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-650-1212
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FRANKLIN COUNTY CRISIS CARE CENTER
Provider Second Line Business Practice Location Address:
465 HARMON AVE
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-222-3737
Provider Business Practice Location Address Fax Number:
614-358-4201
Provider Enumeration Date:
12/04/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  377925 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0142229 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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