Ennoble HC Ky PLLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

ENNOBLE HC KY PLLC

Practice address

2 University PLZ Ste 204
Hackensack, NJ 07601-6211

Phone

(551) 295-8223

NPI assigned

Jun 23, 2026

Last updated

Jun 23, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Bradshaw, MDNPI 1316107428

Title

Owner

Phone

(678) 665-2618

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Bradshaw, M.D

  • Hospitalist Physician
  • Sandy Springs, GA
  • NPI 1316107428
  Authorized official Same address or phone

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

{
    "created_epoch": "1782172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1275469488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016202",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENNOBLE HC KY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-665-2618",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Ennis, FNP-C
• Ennoble HC FL II LLC
• Ennoble HC FL III, LLC
• Ennoble HC Ky II PLLC
• Ennoble HC Ky III PLLC
• Ennoble HC Mso Holdco Inc
• Ennoble HC NJ II PC
• Ennoble HC NJ III PC
• Ennoble HC NJ PC
• Ennoble HC TX II PA

• Geriatric Medicine (Family Medicine) Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.